Hepatobiliary scintigraphy in an exacerbation of Dubin-Johnson syndrome.

Abstract

A patient with Dubin-Johnson syndrome was found to have abdominal pain, fever, leukocytosis, and hyperbilirubinemia. Abdominal ultrasound was normal, but computed tomography revealed evidence of acute appendicitis. Acute jaundice developed after an appendectomy, prompting a hepatobiliary scan. Dubin-Johnson syndrome is an inherited disease of hepatic excretory function associated with chronic or intermittent hyperbilirubinemia and deposition of a black pigment in hepatocytes. Most patients are asymptomatic, but abdominal pain and hepatomegaly can occur. Conditions causing the syndrome to be unmasked or exacerbation of hyperbilirubinemia include sepsis, exercise, alcohol, drugs, and pregnancy. In our patient, exacerbation was secondary to sepsis. Jaundice resolved by the eighth postoperative day.