PMC6739701_01
The weight loss in the following 2 months after 1 session of heavy drinking: each cross-mark represents 1 ER visit or 1 hospital admission.
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F1
The patient lost around 23 kg (118 kg to 95 kg) in weight within 2 months (Fig. 1).
Gastric emptying scintigraphy: there was no evidence of gastroesophageal reflux during 90 min of continuous observation. Gastric half-emptying time was 173 min. Delayed gastric emptying suggested gastroparesis.
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F2
A gastric emptying test confirmed gastroparesis (Fig. 2).
Hepatobiliary iminodiacetic acid scan: there was a prompt uptake of the tracer in the hepatic parenchyma. The gallbladder filled with activity within 60 min and activity was excreted normally into the small bowel. The gallbladder ejection fraction was 12% (normal gallbladder ejection fraction is 38% or greater). The patient reported mild pain with cholecystokinin administration.
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F3
Hepatobiliary iminodiacetic acid scan showed a gallbladder ejection fraction of 12% (normal range >=38%), which revealed gallbladder dyskinesia (Fig. 3).
The second abdominal/pelvic computed tomography scan was done 3 days after the cholecystectomy: interval cholecystectomy with expected postsurgical change, barium within the colon apparently from the esophagram 1 month ago, suggesting decreased/delayed bowel motility with no evidence of bowel dilatation or obstruction.
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F4
The second abdominal CT was done 3 days after cystectomy and revealed residual barium in the colon left by the esophagram done 1 month ago (Fig. 4).