Gall bladder removal and liver hemangioma

[klb75]

I have a large  (6.9 cm) hemangioma on the right lobe of my liver and gall bladder disease w/out gallstones (Hida scan--8% ejection fraction).  It is obvious from digestive symptoms that the gall bladder needs to come out.  However, I am concerned to have surgery due to the hemangioma.  Is there anyone in this community who has a hemangioma and has also had gall bladder surgery?  Despite my surgeon's advice that the GB can come out with no problem, I am still concerned.  Also, are there ways to manage GB digestive issues with more than just no- to low-fat diets?  (I am currently eating almost no fat and still have symptoms daily.)  Thanks for any help or advice anyone can provide.


This discussion is related to Low Gallbradder Ejection Fraction.

[Chadelsa1978]

Hi, my husband just had his operation for gallbladder removal  1 month ago and when he had his repeat ultrasound of the whole abdomen the result was a 1 cm probable echogenic nodule or hemangioma was found in his posterior right peripheral hepatic lobe, what does this mean and what is the complication for this finding? He was recommended though by his GI doctor to perform Triphases scan of liver and AFB, alpha feto protein.

[oddonormal]

Do you still have problems with the hemangioma?
My hemangioma did not grow / has only moderate growth of 0.5cm since the last 6 months (that is within the measurement tolerances)
A few weeks ago I ordered a stool analysis because of my persisting rumbling intestines. The pancreas -elastase (bELST) is below the limit.- Now I take pancreas enzymes (Kreon) which gives me a little relief with my gastrointestinal problems. It is no solution, but it helps a little bit.
One of my doctors mentioned that embolization of the hemangioma might be a solution. Now, I have read that embolization has a high risc of turning into an abscess and that most european surgeons favour a enucleation (if possible) or a resection.
Did your doctor mention which method would be best for you?

[klb75]

I have not had my hemangioma removed since the surgery is major (similar to a liver transplant) and, as of last January, it hadn't grown.  However, I'm getting ready to have it re-imaged this month and will have to revisit removal.  It has taken me over a year to recover from minor gall bladder surgery and I still have phantom gall bladder pain (along with a whole other bunch of health issues I think that have been caused by the stress).  As well, I believe that much of my URQ and side pain is due to the hemangioma stretching the liver capsule (which can be relatively painful).  

I have had and continue to have symptoms similar to yours though not elevated temperature (everything else, though).

I will let you know what I find out after my ultrasound--if it has grown, I really have to consider removal.  I will also let you know what other information I find as I research other possible options.  Hang in there!

[oddonormal]

your story is similar to mine.. I also had a gall bladder surgery. Unfortunately, only  some symptoms (pressure under the costal arch, dark  urin, flatulence ) became better. Now I still have dizziness, nausea, in the evening increased temperature (37,5°C), feeling of fullness, reflux-feeling, fatigue, flatulence and sometimes a  pressure-pain in the area of my 6 cm liver hemangioma.
Did you go for the removal of the hemangioma? (enucleation / resection?)

[Cathie777]

Ive been doing a lot of research with people who have giant hemangiomas over 5cm.
The ones Ive seen/read about who had just their gallbladder out...it didnt help their symptoms.
I think the liver hemangiomas are caused by a hormonal imbalance.
I just read Dr. Michael Platt (I believe it was??) book regarding hormones/bio-identical hormones with stories from his patients and I think you will actually relate to the stories. I know I did. It was a big eye opener for me. He is a traditionally trained MD but really has a unique ...and in my opinion...amazing look and approach to things.
The only thing bad about Dr. Platt is his office visits are $600.

[little57]

I saw my GI Doctor on the 27th, and found out that my sphincter is blocked. I will be having a ERCP done on the 30th of this month. Hopefully they can fix it. I will be glad to get rid of the pain. Sorry to hear they only want to do anti-depressants. That's a bunch of ****. I hate it when they keep treating you like an idiot. You know what's going on with your body, they don't. Keep pushing, that's what I did and got results. I was just lucky that I didn't have to find another Doctor. Good Luck and keep me posted.

[klb75]

Thank you for your thoughts--I really appreciate them.  I did see my GI specialist at the beginning of August and she recommended an MRCP for the bile duct.  Had that done and there is dilatation of the duct but not obstruction so this leads me to believe (as I have all along) that I have SOD.  I thought this might have been a possibility before I had gallbladder surgery but, of course, the docs don't want me doctoring myself and were dismissive.  I have a lot of other kinds of vague things going on and I am beginning to think I have dysautonomia which might account for the digestive issues, including SOD.  Anyway, my biggest issue has become finding a doc who thinks outside of the box and doesn't just reach for the anti-depressant medication as the solution to all of my ills.  At this point, the hemangioma, for better or worse, is on the back burner.  Please keep me posted on your progress and good luck to you, too.

[little57]

Sorry to hear that you are still having problems after gallbladder surgery. Have you discussed this with your doctor? Even though you had the gallbladder out, it does not mean that all your issues were addressed. I had a Hida Scan on the 18th, and my gallbladder seems to be working fine, but there is a possibility that I may have a plugged bile duct. This is called SOD (sphincter of oddi) dysfunction. I will be seeing my GI doctor on the 27th to go over all of my test that I have had so far. This condition causes the same symptoms as gallbladder attacks. From what I have researched, it is not easily solved. You might want that looked into. I can understand your anxiety. As for the hemangioma, I sure hope it can be taken care of. Too bad they didn't remove it when they did the gallbladder surgery. Good luck, and I hope things get better for you.

[klb75]

I did have gall bladder surgery in April and have had difficulty recovering.  I don't think that the 7cm hemangioma was in any way affected by surgery but surgery did not resolve all of my URQ pain issues.  I now have to look into removal of the hemangioma because I believe that it is causing some compression issues and pain on my right side and middle back.

To flamingo40--I still have some pain where the gall bladder used to be but most of my digestion issues have been resolved--as long as I eat things that are low fat.  My diet seems more restricted than it was before surgery so it's made me eat more healthy foods.  URQ pain was the most prevalent symptom (with everything I ate) before surgery.  I still have URQ pain but it's more localized and dependent on what I eat.  Back and side pain seem related to the hemangioma and possible adhesions from surgery.  I am wondering if when the liver secretes bile, that it compresses the hemangioma and that causes pain.  All I can say is that it ***** to have a giant hemangioma and I now have major anxiety issues as a result.

[flamingo40]

I can't really help you with your question, but I wondered if you could answer something for me...what are your digestive issues if you don't mind my asking, I wondered because I have several dig issues and have been diagnosed with a 5 cm hemangioma in the liver butting up against my gall bladder as well as a smaller tumor which they say is Focal nodular hyperplasia (also in my liver),
thanks
nancy

[little57]

Most people are born with the hamangiomas and never know they have them. I am very fortunate to have a doctor who explains everything to me in laymans terms so that I can understand everything. (I have high blood pressure and see a cardiologist for that, and he is the one who explained everything to me about the hemangioma.) An ultrasound should be done every 3 to 6 months, depending on the size. I do know that estrogen makes them grow, and they can just grow on their own. As for them killing you, I don't really think they do. You just have to be careful they do not affect other organs. Tell your doctor that you would feel better having it removed if it is stressing you out. After all, you are paying them for their services. You will need to see a surgeon for that. I was surprised to learn that GI doctors do not do surgery, they just do the testing and then refer you to a surgeon. My hemangioma was found by accident also. They were actually doing an ultrasound on my gallbladder when they found it, and like you, it scared me to death. You can actually have quite a few hemangiomas at one time. So by all means, talk to your GP and let her know that you want them to keep an eye on it by ultrasounds. Good luck!

[boi1]

Thanks,
I'm going to see my gp tomorrow and see what see says about this matter and I'm going to ask her to set up a ultrasound for me and see whats going on. So they can monitor the size with ultrasound?? I don't want another cat scan.  Do you think it should be removed concerding the size?  It just scares me to think this could kill me i not really sure if it could but i'm upset about it.  I just think the gasternolgerist should have been better about explaing things to me than just to say it's just a hemangioma it requires no follow up.  Do you know what makes them grow?? I'm sure i've had this for years and they found it by accident.  Any other input would be great.
Thanks
Boi1

[little57]

Actually the pain you are experiencing is caused from your gallbladder, not the hemangioma. Hemangiomas are dilated blood vessels that are entangled. They see them as non-cancerous tumors. If they get too big or interfere with other organs, then they remove them. You should be having an ultrasound every 3 to 6 months to keep track of it's growth. If you don't feel comfortable with your doctor not wanting to remove the hemangioma, then get a second opinion. I have a small one that is less then a cm and my doctor said they usually don't do anything with them until they are 5cm or larger.

[boi1]

hi this is a bit related to your story not the gallbladder part but i am asking about the
hemangioma mine is six point fiev cm in dec and i say the dr and he said itis just a hemangiona not to worry about it but i feel some discomfort on my right side under rib casge and center of my chest betweem rib cage what do you think could this mean it is getting bigger could this kill me

[Tam828]

I have a similar experience...gallbladder low ejection fraction of less than 20% and many hemagiomas (3 are greater than 5cm in size).  Surgeon has said he can take out the gallbladder but I am concerned about the liver.  He stated it is not a problem.  They simply lift the liver during surgery.  I have taken a couple months so far and still have made no decision.  Has your situation changed since your last post?  Did you have any other tests or diagnosis?  I have pain frequently that is bearable and probably hemangioma pain.  Then every second month or so a gallbladder flareup that lasts a few days to a week.  Please post any progress you have made.  Thanks!