Sorry to bug everyone again..but we are visiting a surgeon on Thursday for my 19 year old daughter after the GI said nothing was wrong. She had a HIDA scan 2 weeks ago..the gallbladder did not visualize well after 60 minutes, so they had to give her morphine & then her ejection fraction was calculated at 32% after an hour. The report said chronic cholecystitis as the diagnosis. No other test showed anything wrong..no stones, no elevated blood levels, no hernias or ulcers, etc. Her symptoms are consistent with gallbladder problems, nausea, pain in RUQ, etc..
Obviously her gallbladder is not functioning properly. Will it EVER function normally again? Has anyone ever had a 2nd HIDA & it was better?
I want to be as prepared as I can be for this appointment on Thursday.
Also...18 months ago, when she saw a different GI, he prescribed Bentyl after her negative EGD and ultrasound & it helped some. i have since read that Bentyl is sometimes prescribed to settle down the gallbladder spasms..(it is an anti-spasmodic drug)..however his diagnosis was IBS & that is why he gave her the Bentyl... anyone have any experience with Bentyl??
I'm not sure if acute cholecystitis ever goes away on its own. Its an inflamation of the gallbladder - What is causing it might may decide if it would go away on its own.
Hida scan is 95% accurate. These thigs can give you a false reading:
non fasting atleast 4 - 5 hours
recent narcotic use (this includes adderal and ritalin)
Here is some info on Cholecystitis: Acute and Chronic
When inflammation of the gallbladder also affects the bile ducts, cholecystitis results. Cholecystitis is most often caused by stones in the gallbladder that obstruct the cystic duct, thus damming up the bile. Other derivations of the disease are infections of nearby organs and pressure from tumors or adhesions.
THE DANGER: This is a medical alert! The complications--necrosis, gangrene, and perforation of the gallbladder, peritonitis, and occasionally abscess of the liver and pancreas--are serious and require immediate medical care.
In Acute Cholecystitis, pain may appear an hour or more after a meal. The pain is likened to labor pains--agonizing and deep-seated, coming in waves, starting in the the mid-upper abdomen, then shifting to the right side, radiating to the back and toward the shoulder. It can also radiate to either the right or left upper pelvis and is usually accompanied by profuse sweating. Variable jaundice, nausea and vomitting, rapid heartbeat, and temperatures up to 103 degrees are seen. The pain can last from a few minutes to several hours.
Chronic Cholecystitis often occurs after the acute phase has passed. If the cause is gallstones, removal will effect a cure; if the determinants are other than gallstones, the underlying disorder must be identified and treated.
I hope this helps, those who are having symptoms and unsure of the cause.
I have experience with Bentyl. I had my GB out 2 1/2 years ago.HIDA scan showed 40% ejection fraction = non-functioning GB. I had terrific right shoulder pain during infusion to stimulate gb emptying. I developed RUQ pain in Feb. 2002. I was prescribed Bentyl for SOD symptoms and told it would probably not help. It did not other than mentally because I knew I was trying to get some relief. The drug greatly blurred my vision and I was prescibed up to 40 mg. per 4 hours. It also can cause urinary retention.I eventually stopped taking it except on rare occasion. In hind sight I wonder if my problem was SOD to begin with. I hope this helps and the drug is probably worth a try.
I have read some about SOD...alot of people feel it is one of the reasons for a non-functioning gallbladder when you do not have stones..however..by the time it gets to where your GB is not functioning....does it just not APPEAR to function or is it really not functioning? in other words..is it the S.O. not opening, therefore it looks like the gallbladder is not emptying..when in reality..it can't empty because the S.O. isn't opening up?
Kinda like a car I once had..the battery and the alternator both went out at the same time..the mechanic said "either the alternator failed first & then drained an old weak battery to the point where it was ruined, or the battery stoppped functioning and the alternator wore itself out trying to put juice into a dead battery"..no one knows...
So..what do you do? Is the gallbladder "done"?
Does the fact that the gallbladder had delayed visualization mean anything in addition to the fact that it also emptied at 32%? She was given Morphine after 60 minutes to make the S.O. tighten up, forcing the radiotracer into the gallbladder. There was no problem seeing the radiotracer go into the small intestine. A gallbladder that doesn't show up well on it's own after 60 minutes, but DOES show up after morphine is diagnosed with chronic cholecystitis, not acute cholecystitis.
I am wondering if anyone else has had delayed visualization of the gallbladder & was given morphine ..what the diagnosis was & if they ended up with surgery to remove the GB. Anyone??
I was 18 when I had my gallbladder removed. I expierenced 3 years of agonizing pain which was often blown off by my family doctor as "Gas Pains". I would get it every month or so, to the point where I could breathe. When my mother finally took the initiative and got me an appointment with a specialist, it was diagnosed as Cholecystitis. My HIDA was 39%. He said it would never go away and surgery was the only solution. I don't know much about any of it, I trusted in what the doctors had told me, since it took so long for it to be diagnosed. I am 23 years old now, with 3 tiny scars and I am PAIN FREE. As the doctor described it, Cholecystitis pain is worse then a heart attack. I wouldn't wish the pain on my worse enemy, and I am so glad I had it done. I would have never thought at that age something like that would effect me. It was the best thing I could have done without any complications.
I am experiencing severe right rib pain and right shoulder pain. my gp doc says it's fatty liver but can't explain the pain in my right shouldere. I thought it was because I use a mouse all day at work( the shoulder pain ) but after reading all of this about the RUQ pain and associated right shoulder pain I now wonder if my gall bladder is coput. Someone please tell me what a HIDA test is and also what does SOD mean??
A HIDA scan is done in Nuclear Medicine & involves being injected with a radioactove tracer material that they then watch on a computer screen & watch the stuff move thru your liver, gallbladder and then into the small intestine. If you have a HIDA scan with CCK, they then either give you something to drink or inject a hormone into your IV (CCK) which stimulates the gallbladder to contract, then they take pictures for 30 -60 minutes, look to see how well the gallbladder contracted & give you a ejection percentage. It measures how well your gallbladder does at emptying bile into your small intestine when your body calls for it. Generally anything less that 35% is considered not working well. My daughter's was at 32%, but the surgeon we saw considers that in the "low-normal" range...borderline.
SOD is the short way to write "sphincter of Oddi dysfunction"..a condition where the "valve" that allows the bile to pass into your small intestine is too "tight"..therefore, the bile backs up, causing trouble. It can cause your gallbladder to store bile that becomes too concentrated & produce inflamation, it can cause the digestive enzymes that your pancreas secretes to back up & you end up with pancreatitis. Not sure what damage can be done to your liver. This is the short version of what happens!
Alot of people that write in on this board have had their gallbladders taken out, thinking that it is the cause of their problem, when in reality, it was the "SOD" that caused the gallbladder "GB" to go bad in the first place. so they end up not "cured"...& in sometimes worse shape than before. SOD is difficult to diagnose as they do something called an ERCP..like an EGD, but they continue on right into the bile ducts & then have some kind of instrument that will measure the pressure that the SO has. It is very specialized and has risks like getting pancreatitis or damage done to your ducts.
Because my daughter does not have stones in her GB, the surgeon is reluctant to do surgery, he says it is only about a 60% chance that it will help. If it doesn't help, then she is now missing part of her digestive system and could be worse.
She is going to have a 2nd HIDA scan done in a couple of weeks...the surgeon is having it done somewhere else where they give the CCK in her IV instead of having her drink something & will look at the results & then we will talk again.
It sure is difficult to know what the "right" thing to do is...
I have a pecentage of 21% and lts of "sludge" but no stones present, but he said there was "a heck of a lot of scarring" to my gallbladder most likely caused by stones in the past. I had been experiencing vomitting, pain after eating and a over sick feeling for 13 weeks now. Monday I met with a surgeon who feels that removal is my only option. I have had 3 other opinions all with the same answer: Your gallbladder needs to come out. I am only 23!! Right now I am on a medical leave of absence from my job since this has had such an impact on my ability to do my job.
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