Daughter very ill, nausea, vomitting, high bilirubin

[hartertrail]

My 14 yr old daughter was recently in the ER and has seen our FNP.  Her symptoms are general pain in the abdomen centralized, nausea, vomiting, and her bilirubin test came back high.  Her sister had her gallbladder removed at age 15 because it didn't function.  Naturally thinking that because their symptoms mirrored each other, we went through the normal tests a CAT scan was performed in the ER its results were that she had a normal size liver, no gallstones, a ovarian cyst, and an enlarged appendix with the wall thickening, they also performed a number of blood tests all of them came back fine except a high biliruben level.  The next day our FNP ordered a HYDA scan and more blood work.  The bloodwork came back fine except for a high biliruben level.  The results of the HYDA scan were that the gallbladder was functioning just fine.  She is still very ill, the FNP suggests that she eat a no fat diet for 4 weeks, if the pain doesn't subside then she will refer us to a surgeon.  I have been researching High Bilirubin and am alarmed at the types of diseases it is linked with.  Is there any test I should be looking for or is it time to go to a gastroenterologist or a liver specialist?  I do recall my liver being enlarged when I was a child, but they put me on medication and it ended up being just fine.

[boron]

Did she have more specific liver tests (liver enzymes and hepatitis)?

[hartertrail]

No, just the normal tests nothing specific CBC.

[boron]

To check for liver disease she needs a blood test for liver enzymes, called a "hepatic function panel". Maybe she should be tested for hepatitis also.

If all tests of gallbladder came out negative, then gallbladder isn't the likely cause of elevated bilirubin. But there still may be a "functional disorder" of the biliary duct. This should be evaluated after liver tests, if necessary.