Two weeks back my mother ( 54 years ) had pain in the abdomen and at back, we thought of it as gastric and treated it so. The pain got relieved and she caught fever. Then we took a tablet for fever and she got well.Last week again the pain started and this time we consulted a Gastroentrologist and he suggested Ultrasound. Ultra sound report showed swelled CBD (Combined Bile ducts) and swelled PD (pancreatic duct ) and mass lesion. She was admitted and further tests like CECT and MRCP confirmed the mass lesion and its size (aprrox 11*23*40 mm). CA 19.9 shows 34.9. She is having mild jaundice ( billirubin = 2.54).Also liver size is increased i.e. 15.4cm. Now ERCP is being done and by biopsy the piece is being sent for analysis. All other reports are OK.
What type of problem it is ?? And what is the remedy ?? Which type of doctor should operate her ?? ( Surgon or Oncologist )
Another Bad Religion - If and when it comes to be defined as cancer, your mother will begin to see an oncologist. I can't pretend to know what kind of cancer it is, it sounds like it. I'm sorry. I just got news myself. I hope everything turns out well..I really do.
ReplyDeleteabijann - *The liver makes bile. The bile flows from the inside of
ReplyDeletethe liver, though tube like structures (known as ducts)
to the gallbladder to be stored and concentrated.
*When we eat, the food will eventually move into the
first part of the intestines, known as the duodenum
(from the stomach).
Hormones are then released that makes the
gallbladder contract and this forces the concentrated
bile into the "common bile duct" and it flows down to
the intestines to help emulsify the fats we eat so they
can be digested and absorbed into the body.
*The pancreas also has a duct coming from it. The
pancreas make insulin, but it also makes lipase
and amylase. These are enzymes which help
digest the fats, also, and carbohydrates we eat.
These enzymes flow down to the intestines, also.
Important: The pancreas duct connects to the
Common biliary duct just before it reaches the intestines.
*Gallstones are known to form inside of the gallbladder
and may move into the bile duct. These stones can
move down and not only block the bile from getting
to the intestines, but also the pancreas enzymes, also.
However, a stone is not the only obstructive thing known
to do this...a growth, like a cyst, tumor, cancer, etc can
also form in the ductal area.
*An ERCP is a very good test to have done.
(endoscopic retrograde cholangiopancreatography)
They use a scope with a light on the end and a camera.
They slide the scope though the mouth (they will
numb the throat and ask the patient to swallow the end and
then sedate the patient)...the scope goes through the esophagus,
to the stomach and over into the intestine, to the biliary area.
They can shoot dye up into the bile ducts and can see more
clearly what is taking place. They can also put small
instruments through the scope to widen the bile ducts,
remove or break up a stone, do a biopsy and do other things
necessary.
They also check out the pancreatic ducts while there.
Here is a link that explains this:
http://www.gihealth.com/html/education/ercp.html
.................................................................
*Bilirubin is a greenish/ brownish substance
(also known as a pigment because it colors other things)
that the liver takes from the blood and converts into a soluble
form to become Part of the bile.
When there is a blockage in the bile ducts, this
bile/bilirubin will back up into the liver and can damage
the liver cells. The bilirubin will stay in the blood then and
go higher on the blood tests results...this is what causes
the yellowing of the whites of the eyes and skin and
causes the darkening of the urine. Since the bilirubin isn't
reaching the intestines, the bowel movements will become
much lighter in color and almost grayish white.
*Back to the liver cell damage: when the liver cells become
damaged, the immune system of the patients body will
respond to this and cause inflammation to develop inside
the liver. This will cause the liver to enlarge in size.
If this is a benign tumor, they might operate to try to remove it.
If you want a second opinion, I would have it done by someone
that has a connection to a Transplant Center...a hepatologist and
maybe an Oncologist. Hepatologist are specialist in the field
of Liver/Biliary Disease. Gastroenterologist are specialized
medicine doctors of the digestive system as a whole...but not all
of them are trying to specialize in just one area like the liver or biliary
area.
I hope this information is of some help to you.
Best wishes