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What Do My USG And CT Scan Reports Indicate While Treating Obstructive Jaundice?

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Posted on Wed, 24 Feb 2016
Question: Dear Doctor ,

My mom is diagnosed with obstructive jaundice. We have done the USG and CT scan. Here, I am giving the impression
1. Hepato megaly with obstructive jaundice- ? most likely due to segmental narrowing of CHD at the region of porta
? Chronic inflamatory
? Neoplastic

2. Gall bladder contracted.

She does not have any fever or pain. She only has elevated bilirubin...Please suggest what's the scenario
doctor
Answered by Dr. Vivek Chail (30 minutes later)
Brief Answer:
There is a probability of chronic inflammation or early cancer

Detailed Answer:
Hi Pgupta087,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. The liver generates bile which is transported through tubes called hepatic ducts one from each lobe. The hepatic ducts from right and left lobe of liver join to form the common hepatic duct which continues downward and joins the cystic duct to form the common bile duct.

2. There is a suspicious narrowing of lumen in the common hepatic duct in the report attached. The narrowing is causing upward increase in diameter of the left hepatic duct. Therefore there is a probability that something is causing obstruction to the flow of bile through the left hepatic duct and common hepatic duct.

3. Such an obstruction is commonly from an inflammation if no mass is seen in the region. However rarely it can be from an early cancer in the area.

4. The liver is enlarged and this is not significant of any particular problem.

5. The gall bladder is shrunken and this can happen in normal and abnormal conditions.

In conclusion the findings are likely to be from a long time inflammation causing narrowing of the common hepatic duct or in a case of early cancer. Your doctor might require a MRCP investigation which is a MRI scan to see the area of narrowing clearly.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (2 minutes later)
Thanks for the reply doctor.

If it is early cancer, it it curable? What is the risk factor of chronic inflamation? Which of these two disease is most likely.
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
If there is sudden appearance of symptoms and weakness then cancer likely

Detailed Answer:
Hi Pgupta087,
Thanks for writing back with an update.

1. It is difficult to say with confidence that it is cancer based on report only because clinical symptoms and history of illness is important.

2. If she is having significant loss of weight, tiredness and anemia then cancer is more likely.

3. On the other hand if she is having jaundice for long time then inflammation is likely.

Therefore a detailed history of problems is important to make a suspicion of whether it is a cancer or inflammation. However if her general health is good then cancer is less likely.

I have myself worked in cancer research institute for few years and sometimes it is difficult to tell in early cancer. Sometimes there can be a benign stricture which is a non cancer growth and this will be known only after MRCP and close follow up over next 3 to 6 months. Cancer in this area is delicate and treatment is not always curable.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (2 hours later)
Dear Dr. XXXXXXX

It's great to talk to you. As I told you, She does not have any fever, or any pain, not even loss of appetite. Over time, the bilirubin count is reducing. It was 23 at the beginning and then it came down to 18 and then to 15. In fact, the yellowish tinge is reducing. As of now only her eyes are yellowish. The other parts are of normal colour. Most of the time , she is having normal colour urine. In fact, she feels hungry all the time. Though she lost weight before, but now she is regaining it. As for the clinical history, she had gastric ulcer diagnosed long back in 1992. later she had cholesterol. And she has the habit of consuming over-the-counter drugs. She has gastriritis and constipation. She takes ayurvedic laxative for dealing with constipation
doctor
Answered by Dr. Vivek Chail (24 minutes later)
Brief Answer:
It looks cancer is less likely but close follow up is important

Detailed Answer:
Hi Pgupta087,
Thanks for writing back with an update.

1. It is nice to discuss the matter with you. From your query it looks less likely to be a cancer.

2. However medicine is a challenging science and it is better to follow up closely when the patient is a loved one.

3. In your situation I will suggest to have the liver function test done in detail regularly to know any sudden elevations in bilirubin and liver enzymes.

4. Using of over the counter medicines should be decreased.

5. She can get a complete blood count done and get her medicines for cholesterol reviewed. Let her eat what she likes and include fibers in diet to avoid constipation and drink adequate water.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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What Do My USG And CT Scan Reports Indicate While Treating Obstructive Jaundice?

Brief Answer: There is a probability of chronic inflammation or early cancer Detailed Answer: Hi Pgupta087, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. The liver generates bile which is transported through tubes called hepatic ducts one from each lobe. The hepatic ducts from right and left lobe of liver join to form the common hepatic duct which continues downward and joins the cystic duct to form the common bile duct. 2. There is a suspicious narrowing of lumen in the common hepatic duct in the report attached. The narrowing is causing upward increase in diameter of the left hepatic duct. Therefore there is a probability that something is causing obstruction to the flow of bile through the left hepatic duct and common hepatic duct. 3. Such an obstruction is commonly from an inflammation if no mass is seen in the region. However rarely it can be from an early cancer in the area. 4. The liver is enlarged and this is not significant of any particular problem. 5. The gall bladder is shrunken and this can happen in normal and abnormal conditions. In conclusion the findings are likely to be from a long time inflammation causing narrowing of the common hepatic duct or in a case of early cancer. Your doctor might require a MRCP investigation which is a MRI scan to see the area of narrowing clearly. Hope your query is answered. Please do write back if you have any doubts. Regards,