False-Positive Liver Scan Following Colectomy

Abstract

To the Editor.— The purpose of this letter is to report an interestingly abnormal liver scan in a normal liver. A falsely abnormal liver scan was obtained in a patient following total colectomy. True normalcy of the liver in this case was confirmed by liver function tests, liver biopsy, and, finally, laparotomy. To our knowledge, this type of observation has not previously been reported in the literature. A 27-year-old man with Crohn disease and carcinoma of the colon underwent total colectomy. His preoperative liver scan (Figure, top) was within normal limits. The postoperative liver scan (Figure, bottom) was apparently abnormal, characterized by heterogeneous colloid uptake and focal defects in the liver and increased splenic uptake. This may erroneously be attributed to parenchymal liver disease with possible portal hypertension. In this patient, however, there was no disease in the liver, as evidenced by normal liver function tests, liver biopsy, and laparotomy.