Bile duct obstruction and enlarged spleen

[hagbag50]

My husband,who is 58 and a non-drinker, has raised LFTs, notably ALP, AP, Bilirubin and GGT. Do not have the numbers.  We are told this indicates biliary tract obstruction.  However, two ultrasounds have found no stones, but have shown up an enlarged spleen - 18cm.  We have known for 4 years that he has a low platelet count although no further investigations were done at the time.  Now we are told that the spleen is gobbling up the platelets.  His platelet count is steady at about 60,000, his WBC is on the low side but nothing drastic,RBC is normal.

At the moment he is under the haematologist, who wants to do a bone marrow scan.  We are worried that he should be seeing a liver specialist.

We would like to know if the bile duct blockage can damage the liver and cause the spleen to enlarge, and is this serious?

He seems quite healthy and has no symptons apart from recurring, mild nose bleeds, and one known episode of micro haematuria.

[Kevin Pho, MD]

Bile duct blockage can lead to some of the symptoms you are describing.  

If the ultrasound is negative, you may want to further investigate the biliary ducts to ensure there is no blockage.  Stones or cancer can lead to blockage that may not be detected by ultrasound.

Specific tests to look at the biliary ducts would be an MRCP or ERCP, and I would consider these tests with your personal physician.  

If negative, a liver biopsy can be considered for further evaluation.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

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, M.D.
kevinmd_b

[gurp]

A related discussion, enlarged spleen,  low platelets was started.

[PandaCat]

I have ITP, which is a low platelet count. Nosebleeds are a somewhat common occurence with this disorder. Good to be in the care of a hematologist

[hagbag50]

Thanks for replying and for offering a positive outcome.  So glad your dad is on the mend.

[AfricanGrey]

My father just recently got out of ICU for a blocked bile duct of the liver.  It was very serious in his case.  He had numerous specialists, not just one.  I'm sure every case is different.  He also had many of the same symptoms it sounds as if your husband has.  My dad ended up getting a bad bacterial infection in his blood stream from the blockage it started affecting numerous organs in his body including his heart.  It was very scary for all of us.  He was too sick to have surgery but needed immediate surgery to remove the blockage.  Somehow miraculously it became unblocked on it's own and things got rapidly better from there.  I hope you get the answers you are looking for.  Good luck.