Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Question Title: Bile Duct and ERCP

Forum: The Gastroenterology and Liver Diseases Forum
Topic: Gastroenterology - General


I have written in before and have appreciated your response. I am writing to give a summary and a happy ending to a rather long process. I am a 45 year old male in good health who started suffering from upper stomach pain about 4 years ago. The pain was like an intense spasm that would be incapacitating and followed by some nausea. I was treated with antispasmotics and tranquilizers after showing normal blood and liver tests. After going through this for about 2 years I had a pancreatic attack with an amylase over 6000 and a lipase over 1700. At that time, I had an ultrasound which was normal followed by a normal CAT scan and a normal upper GI barium swallow. I continued for about another 1.5 years with the chronic pain before I was referred to a GI doc. He visited with me and recommended a Lap chole for the removal of my Gallbladder. The procedure went fine with a normal choleangiogram and no stones present in the gallbladder. I noticed some improvement in upper right quadrant discomfort but I still suffered from these strong spasm like pains which come on ever day or 2. After about 5 more months of this, I went back to the GI Doc. He did a Liver and Pancreatic Panel which were normal and then he recommended an ERCP. I had the procedure done and they found edema in the area of the middle duodenum and the ampulla of vater, a tight diverticulum in the area of the ampulla, a normal pancreatic duct, and a small stone distal to the common bile duct. The stone was removed by retrograde spincterotomy. That was 1 month ago and the relief from the strong spasms was immediate. Over the following weeks, I have noticed much better digestion and a feeling of a much "calmer" stomach. A follow up EGD several days ago showed the swelling in the area of the middle duodenum and ampulla has gone down dramatically. I feel like a new man. Your statements of recommending follow up tests have proved invaluable to me and I thank you. My only suggestion to all patients that write in is to get a thorough workup even when the obvious tests are negative. My Gastro Doc was genuinely suprised to find the stone after all the other negative tests. Thanks for all your help.
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We are happy that we could help you
HFHSM.D.-rf




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