Our gastroenterologist (GI) is recommending that my aunt (72 years old) under go Magnetic resonance cholangiopancreatography (MRCP). This is because a dilated common bile duct (size=1 cm) at the pancreatic head was discovered during an abdominal ultrascan. The GI feels that the dilation could be due to either stones (gallstones), lesion, inflammation or strictures.
I understand that MRCP is usually done using a contrast dye (gandolinium?). Our nephro initially opposed the procedure but after seeing the ultrasound report, opted out by saying this is not his area. Our PCP feels that we should wait until her GFR improves (her recent GFRs range from 27-31).
Earlier, our GI recommended an ultrascan with contrast and this was also opposed by our nephrologist and GP. It seems like we're trying to choose between two organs. Can someone with GFR ~30 under MRCP? The GI said that the procedure could be done using less contrast material, but I'm not reassured by this. [Btw, this is the same GI that recommended a liver biopsy when I had fatty liver 10 years ago! I mean, 1/3 of American have fatty liver!]
On the other hand, I don't want this CBD dilation to go unnoticed because it could be lesion and suggest cancer of the CBD or pancreas. Has anyone undergone MRCP with comprosied kidneys?
A deciding factor could be the clinical symptoms, if she has jaundice, nausea, vomiting, abdominal pain or fever, then you could opt for the procedure. Also, the liver function tests could be another marker to go by for the procedure.
Hi, thanks for your comment. No jaundice. No fever. Some nausea and she did vomit once but we thought that was because she started new hepatitis B medication, Baraclude, which could induce nause and vomitting. She normally has elevated AST and ALT (50-60), due probably to chronic HBV. Since February of this year, her Alkaline Phophatase started increasgin from about 175 to about 300 now. I understand that this level of ALP could be due to CBD dilation. Our GP and nephro don't seem that concerned with her very high ALP. Our GI is very concerned about her high ALP and want's MRCP done, in spite of her declining kidney function.
Copyright 1994-2016 MedHelp International. All rights reserved.
MedHelp is a division of Aptus Health.
This site complies with the HONcode standard for trustworthy health information.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.