Hepatobiliary scintigraphy in an immunosuppressed patient with hepatocellular dysfunction and acute cholecystitis: diagnostic dilemmas posed by delayed gallbladder visualization.

A case of acute cholecystitis in an immunosuppressed patient with hepatocellular dysfunction is reported. The diagnostic dilemmas posed by the lack of specific sonographic findings, the possibility of acute gallbladder disease without early cystic duct obstruction, and the absence of clear guidelines for the interpretation of delayed appearance of the gallbladder on hepatobiliary scintigraphy in this subgroup of patients are discussed.