[en] Full text: A 37-year-old male presented to his general practitioner after 3 days of persistent RUQ pain. An abdominal ultrasound (US) revealed only a 5 mm polyp adherent to the gallbladder wall. The pain continued, and following 2 further US investigations, no appropriate pathology for the pain had been identified. It was noted on US that the right kidney was extremely difficult to visualize and had a mildly dilated upper pole. An intravenous urogram was performed to assess the status of the kidneys and demonstrated a non-obstructed horseshoe kidney. Diuretic renal scintigraphy was then performed to confirm the absence of obstruction. A gastroscopy also failed to elucidate a suitable explanation and, due to the patient's ongoing colicky pain, re-evaluation of the gallbladder was requested. The patient returned to nuclear medicine for hepatobiliary scintigraphy. Initial dynamic images demonstrated normal filling of the gallbladder, but following administration of cholecystokinin there was minimal clearance of activity (gallbladder ejection fraction 20%). The patient's pain was reproduced during the ejection period. These features typically suggest chronic cholecystitis and/or cystic duct syndrome. Consequently, the patient went on to laparoscopic cholecystectomy and his symptoms were alleviated