Role of morphine administration with 99m-technetium-labelled di-isopropyl iminodiacetic acid in the diagnosis of acute cholecystitis

Patients presenting with a clinical diagnosis suggestive of acute cholecystitis had a 99m-technetium-labelled di-isopropyl iminodiacetic acid (DISIDA) scan. Two groups of patients were investigated. In group 1, 66 patients underwent cholescintigraphy and after 60 minutes morphine was given to all patients whose gallbladders had not filled. The accuracy rate of this procedure was 91%, sensitivity 83%, specificity 97%, positive predictive value 96,2% and negative predictive value 87,5%. In group 2, 97 patients had cholescintigraphy with morphine being administered at the beginning of the procedure. The accuracy rate of this investigation was 97,9%, sensitivity 100%, specificity 96,6%, positive predictive value 95% and negative predictive value 100%. We recommend the early use of morphine in all patients undergoing a DISIDA scan for acute cholecystitis