Bile Duct and ERCP

Posted By James on December 10, 1998 at 01:37:39:







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.