Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|sue-ann - Thu Feb 23, 2006 9:28 am||
I am a 40-year old female. I have been having severe pain on my right side just under my rib cage for the past month. I had gallbladder surgery 3 years ago. I have a history of kidney stones, and just prior to this pain starting, I passed one on the same side. I have had numerous blood tests, ultrasounds and CT scans but with negative results. The doctor thought that perhaps a gallstone is stuck in my bile duct, but the surgeon claims he is doubtful as these tests are negative.
When I had my gb surgery, I had similar symptoms, and all their tests were also negative, only to find during surgery that I did in fact have a stone stuck in the duct.
I was pushy with this surgeon and told him this. He has ordered an MRI next, stating that this has to show something, if it's there. He refuses to perform an ERCP if that test is negative.
Is an MRI sure to show a stone?
Should I be considering another gastro problem?
I am not impressed by this surgeon and am going to return to the one that performed my gb surgery.
P.S. I am a Canadian and am dealing with Ontario health care. (this means extremely long waiting periods for tests)
|Dr. Tamer Fouad - Fri Feb 24, 2006 1:56 pm||
ERCP provides both diagnostic and therapeutic options, and has a sensitivity and specificity of 95 percent for the detection of common bile duct stones.
CT and Magnetic resonance imaging (MRI) data combined with the latest computer technology can be used to generate a three-dimensional image of the bile duct. Both these methods are now comparable to the ERCP in terms of diagnostic accuracy.[1,2]
If you do not feel comfortable with your doctor then I recommend you seek a second opinion, especially if you continue to be in pain.
1. Neri E, Caramella D, Boraschi P, Braccini G, Lehmann ED, Perri G, et al. Magnetic resonance virtual endoscopy of the common bile duct stones. Surg Endosc 1999;13:632-3.
2. Coakley FV, Schwartz LH. Magnetic resonance cholangiopancreatography. J Magn Reson Imaging 1999;9:157-62.
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