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Gastroenterology (Expert Forum)
Bile Duct obstructed
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Bile Duct obstructed
by jcupo58, Apr 12, 2006 12:00AM
47 Year old male
Spinal Cord Injury in 1980
Gall Bladder removed in 1986
Recently, developed fever, chills, urine turned amber - then became jaundice.
Bilirubin was elevated - Doctor performed ERCP.
After 1 week repeated blood tests. Listed are out of range results:
Total Bilirubin - 1.9
Direct Bilirubin - 0.7
AST [SGOT] - 93
ALT [SGPT] - 199
ALKALINE PHOSPHATASE - 190
TRIGLYCERIDES 264
CHOLESTEROL 314
HDL 35
CHDL\HDL RATIO 9.0
LDL 226
VLDL 53
LDL\HDL RATIO 6.46
MCHC 28.7
RDW 16.4
Am still slightly jaundice. nauseous, dizzy, weak.
QUESTIONS:
-Are enzymes at normal range considering ERCP performed 1 week earlier?
-Are Cholesterol readings inaccurate[affected] by liver being damaged? (I always had good cholesterol readings (last time 11 months).
-Is ERCP procedure risky (to pancreas or puncturing anything)?
Thank You
Spinal Cord Injury in 1980
Gall Bladder removed in 1986
Recently, developed fever, chills, urine turned amber - then became jaundice.
Bilirubin was elevated - Doctor performed ERCP.
After 1 week repeated blood tests. Listed are out of range results:
Total Bilirubin - 1.9
Direct Bilirubin - 0.7
AST [SGOT] - 93
ALT [SGPT] - 199
ALKALINE PHOSPHATASE - 190
TRIGLYCERIDES 264
CHOLESTEROL 314
HDL 35
CHDL\HDL RATIO 9.0
LDL 226
VLDL 53
LDL\HDL RATIO 6.46
MCHC 28.7
RDW 16.4
Am still slightly jaundice. nauseous, dizzy, weak.
QUESTIONS:
-Are enzymes at normal range considering ERCP performed 1 week earlier?
-Are Cholesterol readings inaccurate[affected] by liver being damaged? (I always had good cholesterol readings (last time 11 months).
-Is ERCP procedure risky (to pancreas or puncturing anything)?
Thank You
Doctor's Answer
by Kevin Pho, MD, Apr 13, 2006 12:00AM
, Apr 13, 2006 12:00AM
To answer your questions:
1) The liver enzymes are elevated despite a recent ERCP. Repeating the tests to ensure they aren't rising should be considered. An ultrasound and/or a liver biopsy can be considered for further evaluation.
2) Although possible, I am not aware of liver disease leading to a significant shift in the cholesterol level - however, I would repeat the tests to ensure this isn't the case.
3) Pancreatitis, infection, perforation and bleeding are all complications of an ERCP. The complication rate is related to the skill and experience of the endoscopist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
1) The liver enzymes are elevated despite a recent ERCP. Repeating the tests to ensure they aren't rising should be considered. An ultrasound and/or a liver biopsy can be considered for further evaluation.
2) Although possible, I am not aware of liver disease leading to a significant shift in the cholesterol level - however, I would repeat the tests to ensure this isn't the case.
3) Pancreatitis, infection, perforation and bleeding are all complications of an ERCP. The complication rate is related to the skill and experience of the endoscopist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
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Hope you start feeling better soon.
ERCP, as any test, is not 100% safe: perforation and pancreatitis can occur, but not very commonly, especially perforation. Without knowing more about your situation, it's very hard to evaluate: the numbers you give, which I infer are after the worst was over, are generally not very high and could be due to any number of things.