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What does a blockage in bile duct and fatty liver indicate?

DOCTOR OF THE MONTH - May 2014
May 2014
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Radiologist
Practicing since : 2002
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Please help me I am out of my mind with worry. I had my gallbladder removed by laprascopic cholecystectomy 18 months ago. I recovered well after this. Unfortunately I have started with similar pain again and was sent for an ultrasound scan which has found a blockage in my bile duct and a fatty liver. I am worried to death the blockage is a tumour. I am being sent for a MRI scan waiting for the appointment. If it was some kind of tumour would the scan be done much quicker? Can they tell on the ultrasound scan if it is a tumour. Please help me asap I am sat here in a state crying.
Posted Mon, 3 Mar 2014 in Abdominal Pain
 
 
Answered by Dr. Vivek Chail 1 hour later
Brief Answer: Less likely to be a tumor related blockage Detailed Answer: Hi XXXX Thanks for writing in to us. First I would like to reassure you that things are not as bad that you are imagining. In my experience, a benign blockage is the commonest cause of any block after a cholecystectomy. The fatty liver might have existed from earlier but the bile duct blockage may be a recent development. The stricture must be evaluated in detail before the surgeon may take any decision on further treatment. By doing MRI scan, the entire biliary drainage can be studied and the exact location of stricture and its manifestation will be known. Ultrasound can show any possible mass causing pressure on the ducts but not in all patients. A cancerous tumor will always cause significant weight loss and jaundice. As you have not reported these symptoms it is less likely to be a serious condition. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek
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Follow-up: What does a blockage in bile duct and fatty liver indicate? 42 minutes later
PLease find my scan report
 
 
Answered by Dr. Vivek Chail 12 hours later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing back with your report. The findings say that the common bile duct is slightly prominent at 9 mm. This often occurs after cholecystectomy but mention is also made about mild dilatation of the intrahepatic duct. This must be checked with any raised bilirubin levels in your blood. Also there is a doubtful area in the head of the pancreas which has been described as subtle. This is a limitation on ultrasound and needs further imaging by CT scan or MRI scan. The proposed MRI scan and MRCP will help clear the above doubts. The fatty liver can be explained as a part of your build and if the cholesterol numbers are fine then there is nothing to worry about the fatty liver. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek
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Follow-up: What does a blockage in bile duct and fatty liver indicate? 4 hours later
The following sentence doesn't refer to cancer though does it I am worried sick? Also there is a doubtful area in the head of the pancreas which has been described as subtle. This is a limitation on ultrasound and needs further imaging by CT scan or MRI scan
 
 
Answered by Dr. Vivek Chail 27 minutes later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in with an update. Pancreas is an organ that is not completely evaluated by ultrasound in every patient. The reason for this is its location and it being surrounded by gas containing bowel. Since ultrasound is a technique that is affected by amount of subcutaneous fat and the presence of gas in the bowel, a higher imaging investigation is better for you. The finding in your report does not confirm any mass or cancer. It is inconclusive and suggests further evaluation to make sure nothing is being missed. Please do not worry too much, I hope the subtle area in pancreas is normal on higher imaging. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek
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Follow-up: What does a blockage in bile duct and fatty liver indicate? 16 minutes later
So you really dont think it is cancer? what does subtle and hypogenicity mean?
 
 
Answered by Dr. Vivek Chail 7 minutes later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in with an update. After having read through the report sent in by you, I really don't think it has anything to do with cancer but it must be noted that I have not done the scan myself or seen the images. Subtle is used to describe something doubtful and that which is not clear, it does not have any clear margins or boundaries from the rest of the pancreas. Hypoechogenicity is a technical term for a dark area on ultrasound. Therefore the concerned area is dark and not too clear.
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