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CT Report Questions

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We have not actually received a copy of the CT Report but the assistant

at the doctor's office said that the doctor wants to see to

discuss the report but wrote 'CT OK but area of interest does not

appear to be draining'. Any insights from this group would be

appreciated. has an appointment on 4/4 but I hate waiting. He

has been hurting most days in his liver - compared to about one day a

week before. He has not been running any fevers.

Thanks,

Nichole (wife of PSC and UC 08/2004)

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It sounds like there is an area where the bile (supposedly) is not

draining due to a blocked bile duct. This may be the source of

liver pain. The solutions to this are either a percutaneous shunt (a

needle directed into the fluid collection or bile duct near it) or an

ERCP dilation of the bile duct distal to the fluid collection.

Aubrey, MD

PSC '81, UC '90, LTX '98, Recurrence '05

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The solutions to this are either a percutaneous shunt (a

> needle directed into the fluid collection or bile duct near it) or an

> ERCP dilation of the bile duct distal to the fluid collection.

>

Aubrey - Thank you for the response. Do you know which of the options

is better and what factors will determine the option?

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It depends on where the blockage is thought to be and whether the

doctors think they can reach the blocked duct with the ERCP scope. If

it's too far from the hepatic duct, one of the main bile ducts that

leads into the liver from the common bile duct, they won't be able to

reach it and open the duct up. Even if they can get a scope to the

blocked duct, they may not be able to open it up from " below " . So a

PTC, a needle through the chest into the liver may be the only option.

After such a procedure is done, they usually leave a tube inserted and

drained to a small collection bag on the outside. This prevents further

build up and pain. But it then remains a site for infection to get into

the liver and cholangitis to start. So there are tradeoffs to leaving

it in place. I hope this explains things reasonably clearly. If you

have further questions let me know.

Aubrey, MD

PSC '81, UC '90, LTX '98, Recurrence '05

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