new mri

[bjack59]

Hey, it's been about three months since i have been on the forum, not since i became detected.  Since then, I have been transferred to Baylor Clinic - surgery/transplant center.He did an MRI and told me that this is where i needed to be.  As for the liver, the news was good.  The report he gave me states that I am mildly cirrhotic and he feels I can wait for new meds, however he has me on "the list" for a trial when available.  He did say i had gallstones, enlarged spleen and a 1cm cyst is seen in the posterior segment of the right lobe.  No masses are noted. the main portal vein is 1.3 cm.  Significant cholelithiasis is seen. The CBD measures 8mm - mild to moderate intrahepatic billary dilation is noted  He wants me to have an EPCP.  I do not understand much of this - it looks bad to me.  When I first saw tis doctor i told him of the chronic pain if have had for months.  He said his liver partients do not complain of pain. I asked him if the enlarged spleen or gallbladder or other things listed could cause such pain and he said "I don't know" and that was it.  My other dr.(gi/hep) told me months ago this was just part of the disease.  My pain is becoming more intense every week and I have 2 doctors not wanting to help figure out the pain.  Has anyone else experieced chronic pain in the abdomen area?  If anyone understands all of this medical lingo, please reply.   Thanks

[bjack59]

thanks for the info  - I am really sorry you are going through such a rough patch waiting for a transplant -praying for you, you are such a survivor and just a positive person, you have helped so many peopleand i wish you the best.

[HectorSF]

I have never had EPCP done myself. But I have heard of a number of transplant patients having it done. They never said much about it. It is a minimally invasion procedure. Have you had endoscopy? It is very similar but more extensive.

Here is a video for patients:
This patient education video explains ERCP. It first discusses endoscopy and when ERCP is needed. It then describes what happens before, during, and after the procedure.

http://www.youtube.com/watch?v=vnAtuG9ULB4

http://digestive-system.emedtv.com/ercp-video/digestive-system-video.html

Me:
I am on week 11 of Gilead GS-7977 + Ribavirin clinical trial. Undetectable since week 2. I am genotype 1b IL28B CC and a previous null-responder to peg-INF and Ribavirin.

I am basically waiting for my transplant. Could come tonight or heaven forbid, 6 months for now. But sometime soon.
I am going through a rough patch with my liver disease and am just taking it one day and one week at a time.

Cheers!
Hector

[bjack59]

Thanks so much for the info -i really appreciate it.  The hep at Baylor is sending me back  to my gi to have the test done. Can he fix the gallstones at that time?  Baylor doc said removing the gallbladder would not be a good idea unless we have to.  I read this is not an easy test - do you know if this is true or not - hector, i am glad to see you on the forum, what's the latest on you?

[HectorSF]

"enlarged spleen" 1.3 cm portal vein" indicate portal hypertension.

Portal Hypertension

The hepatic portal system carries the blood from the GI tract and spleen through the portal vein to the liver then the blood saturates it's way through the liver tissue (where the blood is filtered and cleaned) and then exits via the hepatic vein before it enters the inferior vena cava and the general circulation. This is needed because this blood has digestive end-products and absorbed toxins from the GI tract and bilirubin from hemoglobin destruction in the spleen. The liver is in charge of processing these substances.
When scar tissue in the liver (cirrhosis) interferes with that blood flow--- pressure can build in the portal vein ("portal hypertension"). Portal Hypertension can cause the spleen to enlarge and varices to form in the GI tract.
---> As the spleen enlarges-- platelets are trapped in the spleen. (The platelet count in the bloodstream falls.) (Platelets help our blood to clot. So as the platelet count falls... bleeding time is increased.)
---> Varices (internal varicose veins in the esophagus, stomach, or intestine). are dangerous because there's a risk that they can burst and bleed (hemorrhage).
---> Portal Hypertension can cause complications like "Ascites" (fluid build-up in the abdomen)

Portal hypertension gets worse over time as the liver gets more scared. This is what causes varices, ascites, edema etc.

hector

[HectorSF]

What is the specialty of the doctor you are seeing at Baylor? A hepatologist?

“Significant cholelithiasis (gallstones) is seen. “
You have many or large gallstones. Gallstones can cause pain in the right upper or middle upper abdomen.
“The CBD measures 8mm - mild to moderate intrahepatic billary dilation is noted “
Another indication of gallstones.

Enlarged spleen means - you have some degree of portal hypertension from your cirrhosis.
The normal portal vein is about 1 cm. “A 1.3 cm portal vein” is another indication that you have portal hypertension.

“1cm cyst” is an abnormal sac filled with fluid in the liver. It is benign and about 5% of people have them. They are harmless unless they grow very large.

He wants you to have an “EPCP” (Endoscopic retrograde cholangiopancreatography)?
It is a procedure done to find or treat gallstones in the common bile duct.

It is rare for people to have pain from liver disease. I am surprised a doctor hasn't said your pain may be from your gallstones…

Enlarged spleen does cause pain unless it is very large is again is very rare.
Gallstones can cause different types of pain.


They will be looking at your gallstones and possibly treating them. That is the most important thing right now.

Good luck.
Hector