Elevated liver enzymes, enlarged spleen

[Guest guest]

Hi to all again,

Chris' gallbladder surgery is put off again because of his spleen

enlarged to twice its normal size and his liver enzymes are elevated

again. The doctor seems totally puzzled at this, which really

reassures us - duh!!! Has anyone ever experienced anything like

this. He is so disgusted again. He eats very little and has a lot of

trouble with nausea lately. He is having an EUS on the l4th. Just

wondered if anyone else had liver - spleen complications along with

their CP. Thanks. Prayers and good wishes for all of you.

[Guest guest]

Hi ,

I haven't experienced the enlarged spleen but I have had the

elevated liver enzymes. My GGT, AST, ALT and Alkphos would

elevate in various combinations and to various highs whenever I

had an attack of biliary colic. So it wasn't directly related to my

pancreas problem although they both co-exist. My biliary colic is

a result of a malfunctioning sphincter of Oddi (SO) and is

commonly referred to as SOD or post-cholecystectomy

syndrome, biliary dyskinesia, etc. Basically what this means is

that the common bile duct is obstructed due to the sphincter not

letting the bile out (or in people with elevated pancreas enzymes.

the sphincter blocks bile and pancreatic juice). The obstruction

can be either functional (nerves not working right for some

reason) or physical (scarring, inflammation, stones or sludge,

etc).

Depending on which liver enzymes are elevated, they can be very

diagnostic for what is going on. For example, certain

combinations within a certain range of elevations can point to

either obstruction in the bile flow or cell death in the liver itself.

Obstruction in the flow of bile usually suggests gallbladder

problems, stones in the common bile duct or even in the ducts in

the liver itself (or other less common causes for obstruction like

tumors, etc). Hepatic cell death is usually seen with the various

forms or viral hepatiits (hep C, B, A etc) or exposure to certain

medicines or even environmental exposures to toxins or

autoimmune or hereditary hepatiits. I wouldn't think that this

aspect of Chris' condition should be too puzzling...however in

combination of an enlarged spleen...it does make an interesting

combiination.

Usually a spleen enlarges when there is either a blood disorder

or an infection. Another instance that can be associated with

pancreas and liver abnormalities is when the vessels that feeds

the spleen becomes obstructed or even reverses it flow. There is

a medical term for this which I cannot remember at this time. But

basically what happens, I think, is that a swollen pancreas or

liver of both will press on the vein / artery (?) that feeds the

spleen because this vessel runs through these two organs. This

can cause the spleen to be deprived of its nutrients and could

cause it to swell. Or it may not be able to drain if the lymphatic

system that runs through it is also obstructed for some reason.

That is why when a pancreas is totally or partially removed, the

spleen has to go too....because there is no way to save the

vessels that supplies the spleen. Off hand, that is the only

association that I know of that could explain his pancreas, liver

and spleen symptoms and signs. Doesn't mean that I am on

thre right track though.......I am just offering you a quick guess

and I may be really reaching towards a really outlandish idea

here......

Hope you and your docs figure this out soon.

laurie

[Guest guest]

hi , I had a distal pancreatectomy in Jan'99 and my surgeon said

that my spleen was 2-3 times larger than normal. So he took that out

as well. Before my surgery, they tought I may have had liver problems

because the blood flow thru my organs was incorrect. It turns out that

I had a thrombosis in my spleen, which is a clog of an artery. The

spleen is next to the pancreas, so when the pancreas swells, it

squishes the spleen. I hope this helps...Jim from vermont

[Guest guest]

There are several infections like Ebstein Barr that can cause both the

liver and spleen to enlarge.

Crystal

[Guest guest]

Hi, Thank you for all the information. I am beginning to understand a

little better what may be going on. I am not sure what their next step

will be other than the EUS on the l4th. He has an appointment with

his PCP (at the request of his pancreatis doctor) on Tuesday. She

wants him to check out the enlarged spleen. I don't understand why

the GI people aren't going to do this. I get so frustrated because it

seems he gets shoved around from doctor to doctor and doesn't ever get

better. Oh well, sorry for complaining. Hopefully he can ask some of

the questions when he goes on Tuesday. At least I get help from this

group and I really appreciate it. Hope you are doing well.

Sincerely, .> ..