Medical MCQ-A 70-year-old male underwent a choledochoduodenostomy for multiple common duct stones. The patient now presents with RUQ abdominal pain. What should be the initial test (least invasive with the best yield) to determine patency of the choledochoduodenostomy?

A 70-year-old male underwent a choledochoduodenostomy for multiple common duct stones. The patient now presents with RUQ abdominal pain. What should be the initial test (least invasive with the best yield) to determine patency of the choledochoduodenostomy?

ERCP

Percutaneous transhepatic cholangiogram (PTC)

HIDA scan

CT scan of the abdomen

Question Category:

Surgery

Correct Answer:

HIDA scan

Description:

A HIDA scan will show excretion of the radiolabeled isotope into the biliary tree, but there will be no flow into the duodenum, indicating that the biliary-enteric anastomosis is occluded. If an upper GI study with barium is performed, visualization of the common bile duct would indicate patency of the choledochoduodenal anastomosis.

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