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What Causes Enlarged Spastic Common Bile Duct?
Age 60, female; 5'4 105 lbs . Had gallbladder removed 13 yrs ago . Pror to removal for 3 years developed intolerance to certain fats. Severe reaction to any butter, not lactose intollerant.. Checked post cholecystectomy by endoscopy for " stone left;" inconclusive, bile duct enlarged. Symptoms: extreme right upper quadrant pain, fever, yellow or dark yellow/orange very oily diarrhea, frothy. Burning, sores on rectum. Muscle aches and pain, sometimes itchy rash all over body, weight loss of uo to 5 lbs within 4 hours of onset. Hospital ER; echogram of liver showed extremely enlarged spastic common bile duct; cautioned to go to ER when this happens... what causes this???
Mon, 17 Aug 2015
hi.
the best advice i could give is to have a follow-up with your surgeon and/or gastroenterologist. in cases like this, the most common possibility is a recurrent stone.. a retained stone would present within a short course after her surgery. her GI doctor would probably do an initial ERCP to look for that possible stone and extract it if possible. along with this, blood examinations to check for liver function and biliary obstruction will also be done. the bile duct dilatation could possibly be due to the obstruction secondary to that stone or other pathology within the biliary tree or the peri-ampullary region. if the endoscopic procedure fails, an open surgery would be the best option. it's not an emergency procedure but there should be a sense of urgency in cases like this, as the symptoms might progress in time.
hope this helps.
good day!!
~dr.kaye
the best advice i could give is to have a follow-up with your surgeon and/or gastroenterologist. in cases like this, the most common possibility is a recurrent stone.. a retained stone would present within a short course after her surgery. her GI doctor would probably do an initial ERCP to look for that possible stone and extract it if possible. along with this, blood examinations to check for liver function and biliary obstruction will also be done. the bile duct dilatation could possibly be due to the obstruction secondary to that stone or other pathology within the biliary tree or the peri-ampullary region. if the endoscopic procedure fails, an open surgery would be the best option. it's not an emergency procedure but there should be a sense of urgency in cases like this, as the symptoms might progress in time.
hope this helps.
good day!!
~dr.kaye
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