FAQ - Cholelithiasis
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can anyone help me diagnose my dse. liver enzymes r normal except for alkaline phosphatase?


all types of hepatitis are all negative. i have history of cholelithiasis. my bilirubin is normal.. does anyone knows what cause for my liver enzyme to elevate but not the alkaline p.?
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Higher-than-normal ALP levels may be due to:
* Anemia
* Biliary obstruction
* Bone disease
* Healing fracture
* Hepatitis
* Hyperparathyroidism
* Leukemia
* Liver disease
* Osteoblastic bone cancers
* Osteomalacia
* Paget's disease
* Rickets
Cholelithiasis is the presence of one or more calculi (gallstones) in the gallbladder. In developed countries, about 10% of adults and 20% of people > 65 yr have gallstones. Gallstones tend to be asymptomatic. The most common symptom is biliary colic; gallstones do not cause dyspepsia or fatty food intolerance. More serious complications include cholecystitis; biliary tract obstruction (from stones in the bile ducts or choledocholithiasis), sometimes with infection (cholangitis); and gallstone pancreatitis. Diagnosis is usually by ultrasonography. If cholelithiasis causes symptoms or complications, cholecystectomy is necessary.  (+ info)

why SGPT and SGOT are elevated in choleithiasis ?


my paper on this is due soon and i cant see any explaination why sgpt and sgot are elevated in obstrutive jaundice cholelithiasis i need big help on this...
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Cholelithiasis means stone(s) in the biliary tract and is relatively non-specific, as it could imply either/and stones in the gallbladder or/and bile ducts.

When there are gallstones in the gallbladder, then the liver enzymes should still be normal, and are often so even with acute cholecystitis.

Abnormalities of liver enzymes including AST/SGOT and ALT/SGPT are indicative of problems such as Mirrizi syndrome, or a stone in the bile duct causing infection/liver inflammation. AST and ALT are really markers of liver inflammation. AST/SGOT is less specific and can also be elevated with muscle breakdown (including heart muscle) and blood break-down (hemolysis).

All abnormalities of ALT/SGPT and AST/SGOT must be worked up to find a cause. If cholelithiasis is found to be the cause, then it must be definitively treated. Treatment may include cholecystectomy, IOC, HIDA scan, and ERCP.

Bottom line is, SGOT and SGPT are only abnormal in complicated cholelitiasis and indicate liver inflammation, usually due to obstruction and infection of the bile duct due to choledocholithiasis or Mirizzi's syndrome, etc. It is in fact possible to have stones and even obstruction with minimal or no SGPT or SGOT elevation, and this is infrequently the case. In these cases, only serum alkaline phosphatase and bilirubin are abnormally high, and the lack of SGPT/SGOT elevation indicates the absence of infection/inflammation. Overall, ALT/SGPT is the most sensitive marker for choledocholithiasis (i.e. stone(s) in the (common) bile duct).

I hope this can clarify things for your paper.  (+ info)

what does a mobile1.4cm echogenic, "shadowing gallstone" mean?


Also what does Cholelithiasis without sonographic evidence of cholecystitis mean?
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In a nutshell.. you have little rocks forming in your organ accompanied by an infection.

Get an immediate treatment.  (+ info)

can any body give me published articles about portal vein being anterior to CBD?


recently a case was imaged by me where i though the cbd was dilatd assuming the normal anatomy of the cbd being anterior to the portal vein, but on laparatomy for cholelithiasis and dialted cbd the dilated anterior structure turned out to be portal vein! i would like to know of any published article about this reversal of normal relation of the cbd hepatic artery and portal vein if reported previously or if any body has encountered such a variation in his practise confirmed either by color doppler( which was incidentally not done in this case) or upon operative laparotomy.
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"In hepatoduodenal ligament, the portal vein lies dorsal (pertaining to the back or posterior part of an organ) and slightly medial (pertaining to or near the middle) to the common bile duct."
[Extract from Page 516, Chapter 28, Portal Hypertension Subtitle:Anatomy of portal circulation: by Lawrence W. Way, MD.)
Medical literature states that Portal vein is posterior to Common bile duct.(Please also see the image of Bilebladder.png)  (+ info)

TACE - in Liver Cancer?


A women of 72 years, having liver cirrhosis and blood sugar, spleenomegaly, cholelithiasis, bronchitism, ashma having a lung capacity of less than 10% is now diagonised to have hepatoma, having 3.7 x 3 centimeters size space occupying exophytic lesion in the right lobe of the liver. Whether TACE is an effective treatment for this patient and what are the risks associated with this TACE treatment.
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This should have been discussed with the oncologist when it was recommended. This is a part of the decision making process. TACE in this case is likely a palliative treatment and it is effective. There is risk of hemorrhage and developing an abscess which could be fatal.  (+ info)

is debris/biliary sludge for 3 month old child is serious?


my child scan report for recurrent vomiting says:gall bladdder partially filled and shows multiple very small hyperechoic foci filling the lumen.no acoustic shodow.very small hyperechoic foci close to one another tightly packed.possibility of debris,biliary sludge.tiny cholelithiasis to be considered.gall bladder shows smooth walls.no GB thickening/edema seen to suggest cholecystitis.no evidence of obstrution/IHBR dilation seen at present.common bile duct is normal and measures 1.3MM.suggested serial follow up studies.
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Well, this is definitely something to ask the doctor because I just had my gallbladder out due to gallbladder dysfunction, I'm 23 and the doctor thought THAT was young to have issues. From what I understand it's usually an issue for older folks..(even though I know 2 younger than 30 yrs old that have had theirs removed). Most of my family has had theirs removed.  (+ info)

Gallbladder Polyps?


Had U/S due to urinary retention. Was 16 weeks pregnant at the time and no problems noted with pregnancy. Only issue on report was

two polyps identified in the gallbladder lumen no signs of cholelithiasis or cholecystitis. Radiologist recomended followp up u/s in one year.

There was no size noted re the polyps. Asked my dr and he realy did not give any info.

Here is the question - if there was concenr re cancer or other serious issue would they just say come back in one year. Also would they investigate during pregnancy if there was any issue to worry about.



thanks
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If cancer was suspected, they would definately pursue this further. Gallbladder polyps can indicate a disease process known as "cholesterolosis" or "strawberry gallbladder". The polyps may actually be formed from portions of cholesterol on the gallbladder wall rather than from the soft tissue of your gallbladder. Have your doctor check your blood cholesterol levels and adjust your diet properly. Good luck!  (+ info)

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