Ileostomy reversal, high bilirubin

My 83 year old mother had a ileostomy reversal about a week ago (ileostomy was for an ischemic bowel) but has not made the recovery that was hoped for.  She is still in a lot of pain (back and stomach) and so sick to her stomach she cannot eat anything so she is getting pretty weak.  She is a very petite woman.  The surgeon was in this morning and said her bilirubin level was up--from a 1.3 when she came in to a 4.(something) now.  He thought this might indicate a gallstone so he has ordered up an ultrasound to look at her bile duct.  I know he did not want to say anything too much more that might cause my mom additional fear, but I don't want to be blindsided either.  Is there anything else we might expect to hear not related to the gallbladder?  When she recently had a UTI a MRI revealed a cyst behind her pancreas but both her doctor and surgeon felt it was benign--at the time of her reversal surgery the surgeon said he would not be up high enough to do a biopsy but he did feel the pancreas and said it felt just as it should.  I appreciate any opinion you are willing to share.  

[Kevin Pho, MD]

I agree with the ultrasound to look at the liver and gallbladder.

Another test to consider would be an MRCP or ERCP to visualize the biliary ducts.  

If negative, you can consider hemolytic anemia, which can be evaluated with a blood smear and haptoglobin level.  

A referral to GI physician can be considered to discussed the MRCP or ERCP.  If hemolytic anemia is suspected, a hematology referral would be needed.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
KevinMD.com