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I have jaundice from the past 30 days.My total bilirubin is 24umol.SGPT is 800.Please help.

 
 
Reply Sun 27 Sep, 2015 11:27 am
I have severe irritation of the skin (itching or "pruritus").Doctors told me that my common bile duct from liver to small intestine is blocked.So it needs to operated.So doctor did ERCP but that was not successfull as the common bile duct was hard and internal bleeding started from thereon.Blood also started coming through vomit and faecal matter.So my haemoglobin went to 8.5,which is below normal.I went through various tests like CT scan and Ultrasound but doctors were unable to diagnose or detect the problem.So finally they did MRCP.
What are the possibilities ? Is there any kind of pancreatic cancer ?
MRCP Report says :-
Liver is mildly enlarged in size measuring (~16.9 cm craniocaudal) outline and signal intensity.No focal lesion seen.Hepatic and portal veins are normal.
There is presence of bilobar intrahepatic biliary radical dilatation with primary biliary confluence is patent.CBD is dilated measuring ~16.8 mm in maximum diameter with distal CBD showing circumferential mural thickening and abnormal enhancement with mural thickening measuring ~ 3.8mm.The CBD is showing abrupt cut-off in the distal region with presence of multiple conglomerating enlarged necrotic lymphnodes seen involving the adjacent pancreatic parenchyma in the uncinate process region and peripancreatic fat.The largest lymphnode is measuring ~ 2.3x1.5cm sized.The lymphnodes are hypointense on T1 and mildly hyperintense on T2.
Fluid level is seen in the distal CBD s/o sludge.No calculi seen.
Gall bladder is distended with mild circumferential mural thickening.No calculus is seen.
Rest of pancreas is normal in size and SI.No peripancreatic collection seen.MPD is not dilated.Spleen in normal in size,outline and SI.
Bilateral Kidneys are normal.
No ascites is seen in the upper abdomen.
Stomach and visualized bowel loops are normal.
Impression :-
Mild hepatomegaly.
EHBO level of obstruction -distal CBD with presence of diffuse enhancing mural thickening of the CBD wall.
Irregular cystic areas seen involving the uncinate process and adjacent peripancreatic fat ? pancreatic tuberclosis with compression in the distal CBD causing EHBO.
Differential diagnosis of infiltrating cholangiocarcinoma of distal CBD with metastatic lymphnode ? cystic neoplasm of pancreas.
Rest of pancreas normal.No MPD dilatation seen.
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Type: Discussion • Score: 0 • Views: 684 • Replies: 6
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ossobuco
 
  1  
Reply Sun 27 Sep, 2015 11:51 am
It is against this site's terms of service to try and diagnose someone online. No reputable doctor would diagnose online. Obviously you need to be seen by a medical doctor. You had an operation, so you probably have a hospital somewhere near you, preferably the best one. May I ask what country you are in?
aayushmanubansh
 
  0  
Reply Sun 27 Sep, 2015 11:59 am
@ossobuco,
I belong to India
aayushmanubansh
 
  0  
Reply Sun 27 Sep, 2015 12:00 pm
@ossobuco,
I am just asking about the chances of pancreatic cancer.Doctors are not able to diagnose properly.
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ossobuco
 
  1  
Reply Sun 27 Sep, 2015 12:05 pm
@aayushmanubansh,
Here in the United States, I've a bias towards teaching hospitals for good care, but I don't know how that holds up in the statistics these days, here. Have you gone back to that surgeon or the department at your hospital to ask more questions?

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ossobuco
 
  0  
Reply Sun 27 Sep, 2015 12:06 pm
@aayushmanubansh,
Here in the United States, I've a bias towards teaching hospitals for good care, but I don't know how that holds up in the statistics these days, here, much less in other countries. Have you gone back to that surgeon or the department at your hospital to ask more questions?

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Miller
 
  1  
Reply Sun 27 Sep, 2015 10:36 pm
Quote:
Is there any kind of pancreatic cancer ?


Why amazes me about this thread, is that any physician would give a patient ( non-medical professional) a copy of his health evaluation expecting him to understand it and moreover, never explain to him the significance of the findings.

Did your physician actually give you a copy of the above report?

Whoever you are, you need to go back to your physician and ask him/her to explain your medical situation.

By the way, I've read and understand your report. But A2K is not a medical site for the evaluation of medical disorders such as those you may have.
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