Cholescintigraphic detection of intraperitoneal bile leakage from a perforated duodenal ulcer.

A 66-year-old woman with known gallstones and peptic ulcer disease presented with acute epigastric pain. Cholescintigraphy revealed nonvisualization of the gallbladder with subhepatic and perihepatic accumulation of tracer. An upper gastrointestinal examination with water-soluble contrast revealed a perforated duodenal ulcer, with leakage confirmed at laparotomy. The gallbladder was intact.