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Gall bladder removed due to gallstones and discomfort. CT scan and blood test done. Any suggestion?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
Recently had gall bladder removed due to gallstones and discomfort. Gallbladder removal was about 6 weeks ago. Due to still feeling the same symptoms on right side of abdomen and back as before surgery, surgeon recommended a CT Scan & Blood test.
Please interpret the following CT Scan & Blood test results:

Blood test results:
WBC 3.78 (low)
RBC 3.92 (low)
Hemoglobin 11.9 (low)
Hematocrit 35.6 (low)
MCV 90.8
MCH 30.4
MCHC 33.4
RDW 12.8
Platelets 223
MPV 10.5
Gran % 41.6
Gran # 1.6 (low)
Lymph% 35.7
Lymph # 1.4
Mono %7.4
Mono # 0.3
Eosinophil% 14.8 (high)
Eos# 0.6 (high)
Basophil% 0.5
Baso# 0.0
sodium 141
Potassium 3.9
Chloride 106
Anion Gap 9.9
BUN,Bld 10
Creatinine 0.6
eGFR >60
Glucose 77
Calcium 8.6 (low)

CT Scan results:

The liver is enlarged at 20 cm. There are two hypodensities in liver parenchyma which are too small to characterize. There is mild intrahepatic biliary ductal dilatation, the largest area measuring 9 mm in width.

Abdominal aorta is normal in course and however with minimal atherosclerosis changes. The inferior vena cava is ectatic.

Left ovarian follicle 

1) Mild intrahepatic biliary duct dilatation 
3) Hepatomagaly
Posted Sun, 4 Nov 2012 in Abdominal Pain
Answered by Dr. Ketan Vagholkar 5 hours later
Thanks for writing in.
The symptoms which you have described are suggestive of post cholecystectomy syndrome. The causes of this syndrome can be varied. But since the CT has been done you need not worry. There is no biliary cause for your symptoms as per the CT. However many patients do experience discomfort .This is due to alterationof the physiology of bile secretion. The gall baldder releases concentrated bile into the intestine when needed for digestion. Now with gall bladder gone the quality of bileis dilute and is continuously released into the intestine. This can cause discomfort especially after afatty meal. This problem will automatically settle with time. You do not have to worry at all.In case if the symptoms are abit distressing then you can take bile acid supplements. Avoid fat XXXXXXX foods for the time being.
The other possibility of pain in the right side could be the enlarged liver. the commonest cause of which is fatty liver. So get the CT rereported as to whether there are features of fatty liver. If present then that needs to be treated promptly to avoid further complications.The radiologist as advised by the surgeon must have concentrated only on surgical causes for the pain while reading the CT.
In view of the two small lesions seen in the liver just ascertain that there is no evidence of malignancy in the histopathology report of the gall bladder removed.
Regarding the various blood investgation reports you just need to take food additives to correct them.
I hope this answers all your doubts. If you still have any querries please write back to me.
With regards
Above answer was peer-reviewed by
Follow-up: Gall bladder removed due to gallstones and discomfort. CT scan and blood test done. Any suggestion? 1 hour later
What is the effect of splincter of oddi dysfunction on the liver? Could it be the cause of the liver enlarging?
Answered by Dr. Ketan Vagholkar 6 hours later
The sphincter of oddi is a protective valve which regulates the flow of bile from the common bile duct to the intestine. Dysfunction of this mechanism will cause flatulent dyspepsia that is mal absorption and discomfort after ingesting fatty food items.
Just dysfunction does not cause jaundice or any sort of liver problem. Only if the outflow is completely blocked will bile accumulate proximal to the block and give rise to jaundice. In your case you never had these problems . So therefore the liver is enlarged due to a metabolic cause. The commonest assocaited with gall stone disease being fatty liver.But if your liver function tests are normal , functionally the liver is normal.
I hope this answers your querry.
With regards
Above answer was peer-reviewed by
Follow-up: Gall bladder removed due to gallstones and discomfort. CT scan and blood test done. Any suggestion? 2 hours later
Thank you
Answered by Dr. Ketan Vagholkar 2 hours later
If you do not have any further querries I request you to kindly rate the service and complete the feedback form.
With regards
Above answer was peer-reviewed by
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