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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Thought To Have Cancer Of An Enzyme Test, Liver Enlarged. Blood Count, BP Is Very Low. Now Gall Bladder Is Diseased. Suggestions?

I have a family member who was thought to have cancer because of an enzyme test. Her liver is enlarged. Her white blood count is 0000. She is in intensive care on a ventilator and having a form of dialysis. Her blood pressure is extremely low. They are telling us her gall bladder is diseased, but she is too weak to have surgery. Also, they believe she has some form on blood infection, but so far, they can not point any direct cause. She has been in the hospital for16 days with the last 8 being critical ICU. Any thoughts?
Fri, 5 Jul 2013
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General & Family Physician,  's  Response
Hi,
Most probably you are talking about carcinoma of gall bladder or its duct( cholangiocarcinoma). Advanced cases result in its obstruction leading to elevated levels of enzymes Alkaline Phosphatase or GGT. Hepatocellular carcinoma, which is a cancer of liver and diagnosed by Alpha Feto Protein ( a tumour marker) is another possibilty causing involvment of gall bladder and obstruction of its duct. In either case obstructed duct causes severe infection in the biliary channels( ascending cholangitis). Both the infection and cancer itself can trigger a severe condition called Disseminated Intravascular Coagulation( DIC). Severe infection by itself causing systemic inflammatory responce( septicemia) and DIC can be the cause of the condition of this patient, both of which require ICU care.
Wishing all the best for your patient.
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Thought To Have Cancer Of An Enzyme Test, Liver Enlarged. Blood Count, BP Is Very Low. Now Gall Bladder Is Diseased. Suggestions?

Hi, Most probably you are talking about carcinoma of gall bladder or its duct( cholangiocarcinoma). Advanced cases result in its obstruction leading to elevated levels of enzymes Alkaline Phosphatase or GGT. Hepatocellular carcinoma, which is a cancer of liver and diagnosed by Alpha Feto Protein ( a tumour marker) is another possibilty causing involvment of gall bladder and obstruction of its duct. In either case obstructed duct causes severe infection in the biliary channels( ascending cholangitis). Both the infection and cancer itself can trigger a severe condition called Disseminated Intravascular Coagulation( DIC). Severe infection by itself causing systemic inflammatory responce( septicemia) and DIC can be the cause of the condition of this patient, both of which require ICU care. Wishing all the best for your patient.