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Unexplained biliary dilatation
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Unexplained biliary dilatation

About 18 months ago I had a bout of burning retrosternal chest pain which spread across my chest, to my abdomen and shoulders. It was not typical of the burning pain associated with heartburn - this was much more severe and widespread. After it persisted for some hours I thought discretion was called for, given the effect on raising both my pulse and BP, and ended up in CCU. I should add that as I am a doctor I was pretty certain the pain was not cardiac, hence the delay. This happened again several times over the next few weeks - twice with my ending up in CCU. (I would have gone more often, but it was becoming embarrassing). All bloods and ECGs (EKG's to you colonials) were always normal. However I went through the works - angiogram (20% blockage of R coronary - no change from 3 years earlier); gamma scan of heart (reversible filling defect under stress); ultrasound - nothing; endoscopy (hiatus hernia - I knew about that, it was diagnosed 20 years ago). So it was put down to GORD (sorry GERD) and I upped the Lansoprazole to maximum. Didn't help that much and I was generally somewhat unwell for the next 8 - 9 months, during which time I had several more bouts of this mysterious burning chest pain. I then had further investigations. Heart - OK, apart from that minimal angina if I tried to walk at the speed I did when I was 40 (I'm now 70). However an abdominal ultrasound showed some kidney cysts (pretty much normal for someone my age) but it also showed a dilated common bile duct. This definitely put the wind up me as the most common cause of this is either stones (no symptoms typical of that) or pancreatic cancer (which has a somewhat short prognosis). A CT scan however showed neither stones nor tumour. Two attempts were made to carry out an endoscopic ultrasound exam, but my oesophagus objected strenuously to the attempts to pass the equivalent of a garden hose down my gullet - can't say I blamed it. So they settled on an MRCP (an MRI focused on the biliary tree. This showed a thin walled gall bladder, and a dilated extra-hepatic biliary tree, with normal ducts in liver and pancreas, and a tapering dilatation from the ampulla of the duct where it joins the duodenum. And my kydney cysts! No cause for dilatation was found. All liver and pancreatic biochemistry is normal.
Last I heard (2 months ago) was that I was to be the subject of one of the hospital's multi-disciplinary clinical meetings (you know, the things that House holds) but I am still waiting for the outcome from that. In the meantime I am pursuing my own line of research - from both a professional and personal point of view. Is this all in my mind? Am I neurotic? Seems unlikely given the findings, and anyway, I discussed it with a psychologist colleague and he (and my GP) doesn't think I'm neurotic so I think we can safely exclude that diagnosis. In the meantime I continue to have bad nights with what I think is the hiatus hernia. But what has caused the biliary problems. And is it worth worrying about at 70!
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This is a miror image of some of my GI symptoms. I am a nurse that is in hot pursuit to research this pior to all diagnostics completed.
Recently developed pain under right rib cage ( anatomical to the liver). Gallbladder removed 1980. CT scan showed dilation of common bile duct. I too have the crazy heartburn you noted. Did you find out th cause of your dilation? All of my lab values good, except HgB 9.0.
Any info helpful
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