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What Does My Lab Test Report Indicate?

Posted on Tue, 12 Jul 2016

Question: I just learned that I have biliary stricture, per an MRCP, no other findings mass, etc. I am being referred to have an ERCP and freaking out. One doc explained the commones cause for an obstruction is a stone. This is followed by a benign stricture and rarely it can be cancer. My doc said she does not have any concerns about cancer. Please advise. I have been crying all day about this.

Answered by Dr. Dr. Ivan Romich (22 minutes later)

Brief Answer:
Stone

Detailed Answer:
Hi and welcome.

Yes your doctor was right, cancer of biliary duct is the last thing to think of, especially in your age. It is generally very rare. Of course, each stricture should be evaluated and cancer should be ruled out. Most common causes are biliary stones, fibrosis or cholangitis but ERCP should show it exactly. If you do not have increasing pain, jaundice and rapid weight loss then there is no need to be worried about cancer.
As known even benign stricture may progress further over a period the time and surgery may be necessary.
WIsh you good health.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (6 hours later)

Thanks for that information. My doctor said the MRCP/MRI would had pick up some type indication as well. I have loss 6lbs within the past 2 months, but I when my anxiety is up I don't eat well and I have cut the sugar out my diet.

Answered by Dr. Dr. Ivan Romich (25 hours later)

Brief Answer:
hi

Detailed Answer:
Yes, MRI is pretty accurate in some lesions and some malignant features would be noticeable. However, sometimes sometimes in cases of very small tumors, the exact diagnosis may be missed. I suggest MRI follow up in 2-3 months,if there is no worsening of stricture then there is no cancer.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Dr. Ivan Romich (1 hour later)

Are you still suggesting it is rare, and not let that be the top worry? Glad to know that about the MRI, as my doc believes it would had see something like that. Doc said my dilated common bile duct had when down since my ultrasound. I appreciate your responses. Most helpful.

Answered by Dr. Dr. Ivan Romich (35 minutes later)

Brief Answer:
Hi

Detailed Answer:
I am glad I can help.
It is true. Obstruction of biliary duct caused by tumor would inevitably show progressive dilatation of proximally placed ducts and intrahepatic ducts. Also,it would lead to progressive jaundice and increasing bilirubin rates.

I understand your concerns, since carcinoma in this area would be very serious diagnosis, but as I said, we rarely see it in age <50 and you would have some MRI features and signs that I've mentioned. Common bile duct diameter can be followed by simple ultrasound as well so you can do it in few weeks and check for possible dilatation.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Ivan Romich (26 minutes later)

Thank you for your time.

Answered by Dr. Dr. Ivan Romich (15 minutes later)

Brief Answer:
Hi

Detailed Answer:
You are welcome. Feel free to ask if you have any further questions.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Ivan Romich (23 hours later)

Another question...If I a CT done a year ago with contrast. They saw a 4mm calcific in my duodenum. A suspected stone. Would that have anything to do with my suspected condition? I am really freaking out again about the this ERCP.I meant I had an abdominal CT scan done last year.Also, Would the CT had shown something related to biliary Stricture?

Answered by Dr. Dr. Ivan Romich (21 hours later)

Brief Answer:
CT would not detect it

Detailed Answer:
Hi

Well, common bile duct and especially hepatic duct are very small structures and CT scan is not sensitive enough to detect strictures unless there is obstructed segment of the duct longer than 5-6 mm which is usually seen in late stages of stricture.

So even if this was present 1 year ago, I don't think that CT would detect it.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Ivan Romich (7 hours later)

One last question, I just received notice that my liver enzymes are slightly elevated. My CA9-19 marker came back fine as well as my gallbladder blood work. Should I be worried being my bile duct issue.

Answered by Dr. Dr. Ivan Romich (38 hours later)

Brief Answer:
can you tell me exact values

Detailed Answer:
Please, write down exact values of bilirubin, AST,ALT and GGT. Then I ll be able to tell more.

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Yogesh D