Freaking out-dilated intrahepatic duct

[k2626]

Ive had left sided pains for 6 yrs, just 6 months after  my dad died of pancreas cancer. My lipase has always been at least 40 pts high since then. The last 2 yrs have been worse, soft bowels always, more constant pain-enzymes do help some. Ive had SEVEN EUS and multiple MRCP in the last 6 yes-all normal UNTIL NOW!

I just had a secretion MRCP and it came back with all sorts of stuff. I had an EUS just 4 months prior that was normal! The most startling finding is a mildly dilated intrahepatic duct. Everything I read says its from pancreas cancer. I flew out of state to see this dr that did this test and he can't see me till Dec when he plans to do an EUS- this was part of the plan before these results. The also noted possible sludge in my gallbladder lumen but the hida scan I had a few months prior did not show sludge, my GB was mildly slow last yr but seemed to resolve.

Anyone, please help. Ive been crying thinking I will die in a few months and I have a little 2 yr old girl. I don't know what to do.

[Tj5939]

What ever happened to you?  Did you find out anything after your last post sept 27,2014?

[k2626]

Oh and BTW had a liver panel done about 2 wks before this test and it was normal. My fatigue and chronic on and off again lg fevers have been going on months. I just redid my ca 19 and will get results on Friday. It HAS been elevated in the past (at most 2x normal so nothing huge) (but has gone back down) with the assumption its from pancreatitis.

[k2626]

Thanks again for your comments. It reads mild intraheptic dilation with focal anterior of 5mm. Also noted the gallbladder lumen had intensity signal and noted likely sludge. I went to the best pancreatitis dr in the country as NOTHING has been showing up on countless EUS or MRCP over the years. In fact, I had a normal EUS and MRCP just 4 months prior. I expected something but not this.

This seems like a big deal to me, but obviously not to him as he didn't call to explain. I had a preplanned visit with him in Dec for another EUS. His nurse said there was nothing further needed outside of what we had already planned. Dec seems to far away and so I proactively bumped it to November.

I emailed two of my local GI drs here and they do not seem concerned.

I feel like none of my drs give a crap, this seems like a really big deal in my opinion and I feel like waiting is life or death!

[fntn]

Of course, with limited data and we not being doctors, we can only speculate as to what's up. With low grade fevers, you could be looking at a bile duct inflammation and/or bacterial infection for instance. This can cause a mild dilation without the need of a tumor and it's far more common.

Did you get your blood serum AFP, CEA, CA19 levels checked as well? Also, did they mention if the dilation a abrupt or soft and gradual? A lesion will tend to cause the abrupt form and inflammation is more of a soft, gradual dilation. That's what I have and it's everywhere due to my benign strictures.

[k2626]

Thanks for your post. Everything I read about intrahepatic duct dilation says "cancer". If there is an obstruction causing this dilation than that freaks me out more. What else can obstruct aside from a tumor? I guess its good my liver panels have been okay thus far? Another concerns is I have had chronic low grade fevers on and off. Im terrified of what will be found and WHATS causing this to dilate.

[fntn]

Keep in mind that elevations in lipase can be caused by many different things other than your pancreas. And it seems you've been getting quite a bit of testing over the recent years so they most certainly would have noted something along the way. So it's very good to have your diagnostic history to work with when you do meet with your doctor. I'm sure he/she would have made an extra effort to meet with you sooner if they did think it was something to be really worried about.

Also, you mention "a mildly dilated intrahepatic duct". Dilations tend to be very close, just upstream of the point of stricture. So it seems your looking at an obstruction of some form that is close to or within the liver itself - relatively far away from the pancreatic/bile duct intersection. If only "a" intrahepatic duct is dilated vs most or several of them, this would also point to an obstruction within the liver and upstream of the common hepatic duct.

Sludge can come and go. It's presence tends to point towards impeded bile flow too. Sludge in your gallbladder can cause a bit of a noticeable but vague ache in your RUQ area. I have it all the time myself.

It's easy to say but do try and stay calm. Hopefully you can get this resolved quickly when you meet with your doctor. Good luck.