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Forum Name: Gastroenterology Topics

Question: Primary Bile Duct Inflammation Again??


 doorsgirl440 - Fri Feb 02, 2007 6:53 pm

I am 31yr old female. In aug. 06 I had gallbladder removed. In Oct. 06 had bouts of same type of gallbladder pain, was told I was prob. constipated. Nov. 06 same pain last almost 2 weeks with several ER visits, finally blood work done liver enzymes were sky high, bilirubin was at a 8. Sent home and told to see doctor. Returned to ER day and half later, was admitted to hospital, suspected stones in pbd. Had ERCP with sphincerotomy(spell) 2 days later, that resulted in small stones and sludge. About 2 weeks later had another ERCP (again sphincer.) where more sludge was found. Since then had lil' sympotoms of right upper quandrant pain that has been bearable. Now pain is beginning to become more consistent and slightly more intense.
Could my ducts be blocked again???
Just getting frustrated on confused...
 Dr. Safaa Mahmoud - Sat Feb 03, 2007 1:35 pm

User avatar Hello,

A condition known as postcholecystectomy syndrome (PCS).
Patients with symptoms after cholecystectomy similar to cholecystitis or gall bladder disease are known to have postcholecystectomy syndrome (PCS).

Causes include:
-Residual or reformed gallbladder (excluded)
-Sphincter of Oddi stricture
-Sphincter of Oddi dyskinesia, spasm, or hypertrophy still possible.

Your history suggest an anatomical complication that results in slow bile flow and stone reformation.

With ERCP, sphincter dilation sphincterotomy sphincteroplasty, biliary bypass, common bile duct exploration (CBDE), and stone removal can be diagnosed and treated.

ERCP with sphincterotomy usually results in recovery of symptoms. If, the patient continues to have intermittent RUQ pain and the condition is not explained enough by ERCP and a normal exploratory laparotomy, a transduodenal sphincteroplasty is considered.

Follow up with your doctor is essential.
Keep us updated
 doorsgirl440 - Thu Mar 01, 2007 11:05 pm

This is somewhat of an update...
I contacted my GI finally they had me go get blood work and x-rays to see if how things were since I continue to have this pain. Everything came back normal. I was told to take some fiber.
Since my post I still continue to have this pain in right upper quadrant. Some days it is really bearable and other days a bit more painful.
Went and seen my PCP last week she had a ct scan w/barium drink and had more blood work done. Again, everything came back normal. She had prescribed me some prilosec. This hasn't taken care of any of my pain and i have been on this for over a week now. My GI had previously prescribed me prevacid and that didn't help either.
This is becoming a frustrating situation! I didn't have any problems until last year it was automatically asumed that I had gallbladder problems after an ultrasound found a stone stuck in the neck of the gallbladder. When I had those attacks they only lasted through the night! Now i have these pains daily. I don't have any other symptoms such as: nausea, fever, no bowl movement problems, do not feel bloating.
I have looked into the SOD and that seems to seem more of what I have. But, how to I present this to my GI without seeming to interfer with his job?
 doorsgirl440 - Thu Mar 01, 2007 11:09 pm

I also wanted to add that during my severe problems during Nov. in having the ct scans and the xray portion of the ERCP they did not see anything causing a problem. It wasn't until my blood work showed the problems. When they went in for first ERCP everything just came gushing out (small stones and sludge).
 doorsgirl440 - Thu Mar 22, 2007 8:56 pm

still continue to have this pain...
If anyone out there has any comments on this please let me know!

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