An image at 60 min of hepatobiliary scintigraphy in a patient with severe jaundice and post endoscopic retrograde cholangiopancreatogray (ERCP) illustrated prominent activity in the liver with a large and distinctive defect in the gallbladder fossa, no activity in the gallbladder, biliary duct and bowel. In addition, blood pool activity in the enlarged heart and renal activity of both kidneys and sign of ascites were also seen. These findings correlated with CT and ERCP radiographic findings showing common bile duct stones, gallbladder stones, and ascites. Dysfunction of the liver and heart failure also contributed to these findings. At autopsy, ascites, gallstones, evidence of cirrhosis of the liver secondary to hepatitis C infection, and cardiomegaly with severe coronary artery disease and myocardia
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