Vicarious Excretion of Intravenous Contrast in Gallbladder with Intact Kidney Function: A Case Report

Author(s): Blerina Saraci, Durim Cela, Elton Ceka, Denis Qirinxhi, Ahmed Dheyaa Al-Obaidi, Alecia Anyim, Elsie Tachie Mensah, Dorjana Sala,Kaltrina Gocaj, Juilda Kolici, Keti Mamillo, Wern Lynn Ng, Juna Musa

Although the kidneys excrete most water-soluble contrast agents, their biliary excretion in patients with non-renal pathology is not well recognized. The definition of the contrast material in the gallbladder, a process also known as vicarious excretion, is a rarely reported event; it usually accompanies obstructive uropathy and kidney injuries. There are, however, case reports in literature of gallbladder enhancement and vicarious excretion in patients with normal blood creatinine levels, and no remarkable existing hepatobiliary problems. In the current case, a 43- yearold female patient with a suspected bowel obstruction received a diagnostic CT-imaging scan showing incidentally an abnormal contrast accumulation in the gallbladder. She had a general unremarkable medical history and did not develop signs of kidney injury while staying in the hospital. Thus, besides describing these radiological findings, we hope to give possible physiological explanations so that this incidental discovery could be better understood if and when found in any other case.