A positional maneuver to augment conventional cholescintigraphy in the evaluation of acute acalculous cholecystitis

Cholescintigraphy is commonly used as an accurate functional complement to anatomic imaging for diagnosing acute calculous cholecystitis. Although less common, acute acalculous cholecystitis (AAC) can also cause right upper quadrant pain, especially in hospitalized and critically ill patients. Moreover, traditional cholescintigraphy, even with morphine augmentation, is less sensitive and specific in diagnosing AAC. We present a case of suspected AAC in a hospitalized ill patient in whom simple physiological augmentation using patient positioning during cholescintigraphy avoided a false-positive result of AAC. The routine use of such physiological maneuvers may increase the accuracy of traditional cholescintigraphy in patients with suspected AAC.