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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedies For Acute Abdominal Pain In Spite Of Cholecsystomy

The patient has had a cholecsystomy done in 1998, and has been suffering repeatedly from cholangytis, has had 3 ERCP done to remove Gall stones, has lithroscopic bile and still has acute abdominal pain. Patient has been on a high dose of anti biotics for past one year. Even has had a tube inserted in the Duodenum-CBD and taken out after 3 months in 2010 for free passage of bile. Suggest remedy. Want to have a check up by Dr A.K. Konar.
Mon, 20 Oct 2014
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General Surgeon,  's  Response
Hi.
Repeated Ascending Cholangitis has too bad consequences.
Is the bile subjected to culture and sensitivity?
I would advise such a patient to undergo MRCP to be done by an MRI. This will give an idea to get a proper diagnosis of the pre-existing problem like a stricture of the bile duct / pancreatitic problems or some sort of mechanical problem.
Also needed is Endoscopic Retrograde Cholangiopancreatography ( ERCP) to pur a stent to drain the bile. The patient needs restenting first to get the bile flow in place, to get to the root cause and to plan a treatment for this.
It is possible that he is suffering from Cancer called cholangio-carcinoma or Canver from Pancreas, Stomach or Duodenum.
Gallstones can form in such situation.
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Suggest Remedies For Acute Abdominal Pain In Spite Of Cholecsystomy

Hi. Repeated Ascending Cholangitis has too bad consequences. Is the bile subjected to culture and sensitivity? I would advise such a patient to undergo MRCP to be done by an MRI. This will give an idea to get a proper diagnosis of the pre-existing problem like a stricture of the bile duct / pancreatitic problems or some sort of mechanical problem. Also needed is Endoscopic Retrograde Cholangiopancreatography ( ERCP) to pur a stent to drain the bile. The patient needs restenting first to get the bile flow in place, to get to the root cause and to plan a treatment for this. It is possible that he is suffering from Cancer called cholangio-carcinoma or Canver from Pancreas, Stomach or Duodenum. Gallstones can form in such situation.