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Family Medicine (Expert Forum)
jaundice
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
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jaundice
by ABD, Nov 10, 2001 12:00AM
My skin tone took on a yellow tone and I have a pain in my upper right side. My doctor performed a sonogram and hida scan suspecting gallstones. During the hida scan I felt the pain when the liver released to the bowel. No stones were detected and she said I had a desteneded bowel. (She alo tested me for Gerards (??) syndrom). Should I be concerned....could this not be a destended bowel? I don't feel the pain in my upper right side all the time, usually only after I eat and it only lasts for a few minutes, but my skin tone definity has a yellow tone to it all the time.
Doctor's Answer
by Forum-M.D.-DT, Nov 10, 2001 12:00AM
It really sounds to me like you have something blocking the ducts from the liver (i.e. common bile duct). I understand that a HIDA scan should demonstrate this, however, your symptoms are very classic for disease related to the gallbladder and/or bile ducts, namely right upper quandrant pain after meals with evidence of jaundice.
The skin usually doesn't appear yellow until the Bilirubin level gets above 2.5 mg/dl. (normal is 0.1-1.0). Something is going on with your liver, in all liklihood and it very well may be due to a problem with the flow of bile from the liver into the small intestine.
If you came to me with this history, the following would be done
1) review the HIDA scan and Ultrasound
2) do a blood test to check for hepatitis
3) do a blood test to check for blood cell abnormalities and determine if the clotting factors (which are produced by the liver) are in the normal range.
I have seen cases where there is gallbladder disease significant enough to cause jaundice, yet with no evidence of "stones". In some cases the gallbladder will be very swollen with a thick-consistency bile present (but not stones). My point is, just because there are "no stones" you cannot rule out gallbladder disease as a possible cause for your symptoms.
I hope this helps and thank you for visiting the Family Practice Fourm.
The skin usually doesn't appear yellow until the Bilirubin level gets above 2.5 mg/dl. (normal is 0.1-1.0). Something is going on with your liver, in all liklihood and it very well may be due to a problem with the flow of bile from the liver into the small intestine.
If you came to me with this history, the following would be done
1) review the HIDA scan and Ultrasound
2) do a blood test to check for hepatitis
3) do a blood test to check for blood cell abnormalities and determine if the clotting factors (which are produced by the liver) are in the normal range.
I have seen cases where there is gallbladder disease significant enough to cause jaundice, yet with no evidence of "stones". In some cases the gallbladder will be very swollen with a thick-consistency bile present (but not stones). My point is, just because there are "no stones" you cannot rule out gallbladder disease as a possible cause for your symptoms.
I hope this helps and thank you for visiting the Family Practice Fourm.
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