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What do my ultrasound test results indicate?

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Posted on Thu, 5 May 2016
Question: Occassional dull ache on lower right side but sometimes fine for days. I had an ultra sound and it showed 7 gallstones and my pancreatic duct at 1.5mm which according to the internet is in the normal range. However the doctor said should be 1.2mm

Now weight loss or loss of appetite. I feel good.

So he sent me for a ct scan.
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Answered by Dr. T Chandrakant (41 minutes later)
Brief Answer:
Needs further evaluation.

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Female/54 - Occasional dull ache on the right *lower side - fine for days - no loss of appetite or weight - feel good - Ultrasound shows 7 gall stones and pancreatic duct of 1.5 mm - sent for CT scan - wants to know the most likely causes...

Since you have noted the dull ache on right *lower side, this can not be caused by the gall stone.
The Pancreatic duct can be seen on Ultrasound to be of varying diameter , the largest being at the head and narrows as it goes to the tail, and hence if the Sonologist has seen this to be at the head, 1.5 is absolutely normal and yest can not cause the pain in the right lower side.

Hence the causes have to be found:
Clinical evaluation and examination by a General Surgeon as the diseases that can be easily detected by ultrasound are ruled out if the whole abdomen must have been scanned. These are the problems related to the uterus, ovaries and Fallopian tubes, the urinary bladder and kidneys, Pouch of XXXXXXX (Deep pelvic cavity), Lymph nodes, Appendix and so on.
It is definitely a wise decision to get the CT scan of the whole abdomen as it may show the cause to get a probable diagnosis.
Also needed is to undergo the tests of stool, urine and blood.

All these things together may give us a proper diagnosis and a plan for management.

Multiple stones in the gall bladder itself is an indication for gall bladder removal by Laparoscopy route and Laparascopy gives an excellent opportunity to see the whole abdomen from within. (Diagnostic as well as therapeutic)

I hope this answer helps you to get a proper line for diagnosis and treatment, please feel free to ask for relevant further queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. T Chandrakant (13 minutes later)
To clarify...the tail is 1.5mm not the head. The doctor said this part should be 1.2mm Does this change your answer.

Also one additional item. Severe stress brings on the symptom,(dull ache).

doctor
Answered by Dr. T Chandrakant (57 minutes later)
Brief Answer:
Think of IBS is the other investigations are normal.

Detailed Answer:
Thanks for your feedback and additional query.
The diameter of 1.5 mm does not change my answer as the symptoms can not be explained by this. Secondly, this is to be taken as normal if the duct is smooth without any irregularity, no stones and parenchyma of pancreas is normal.

Severe stress bringing on the symptoms of dull ache is indicative of IBS, the irritable bowel syndrome. If all other investigation are normal including colonoscopy, the most probable cause can be taken as IBS. Please get investigated fully.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19250 Questions

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What do my ultrasound test results indicate?

Brief Answer: Needs further evaluation. Detailed Answer: Hi. Thanks for your query. To recapitulate: Female/54 - Occasional dull ache on the right *lower side - fine for days - no loss of appetite or weight - feel good - Ultrasound shows 7 gall stones and pancreatic duct of 1.5 mm - sent for CT scan - wants to know the most likely causes... Since you have noted the dull ache on right *lower side, this can not be caused by the gall stone. The Pancreatic duct can be seen on Ultrasound to be of varying diameter , the largest being at the head and narrows as it goes to the tail, and hence if the Sonologist has seen this to be at the head, 1.5 is absolutely normal and yest can not cause the pain in the right lower side. Hence the causes have to be found: Clinical evaluation and examination by a General Surgeon as the diseases that can be easily detected by ultrasound are ruled out if the whole abdomen must have been scanned. These are the problems related to the uterus, ovaries and Fallopian tubes, the urinary bladder and kidneys, Pouch of XXXXXXX (Deep pelvic cavity), Lymph nodes, Appendix and so on. It is definitely a wise decision to get the CT scan of the whole abdomen as it may show the cause to get a probable diagnosis. Also needed is to undergo the tests of stool, urine and blood. All these things together may give us a proper diagnosis and a plan for management. Multiple stones in the gall bladder itself is an indication for gall bladder removal by Laparoscopy route and Laparascopy gives an excellent opportunity to see the whole abdomen from within. (Diagnostic as well as therapeutic) I hope this answer helps you to get a proper line for diagnosis and treatment, please feel free to ask for relevant further queries if you feel that there is a gap of communication.