Dilated Common Bile Duct 9mm

[Logan075]

Ultra Sound Findings:  

There is extrahepatic biliary duct dilation with the common bile duct measuring 8 millimeters.  No evidence of gallstones, gallbladder wall thickening, pericholecystic fluid, sonographich Murphy's sign.

The liver is normal size at 16.9 cm in length.  It is normal in echogenicity.  There are no focal liver masses.  There is no intrahepatic ductal dilation.  The portal vein is patent with normal direction flow.

The head and body of the pancreas are normal.  The tail is not seen.

No evidence of cholelithiasis or cholecystitis.


CT Findings:

Biliary Tract - Common bile duct is dilated measuring 9mm.  There is also mild intrahepatic biliary ductal dilation.

Liver - Normal size.  No mass.  Multiple round subcentimeter hypodensities in the dome of the liver, which is too small to characterize.

Pancreas - No focal or diffuse pathology.
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Basic emergency room blood work normal at time of scans.  Bilirubin was elevated 3 months prior at onset of acute symptom presentation.  Symptoms are nausea, lightheadedness/dizziness, general intense malaise,  stomach distention/bloating, RUQ tightness/mild to moderate pain, swollen feeling, extending around RT flank,  occasional shakiness with feelings of passing out, occasional shortness of breath/chest tightness.  Diffuse pain on LUQ and around flank. Sharp pain on palpation of RUQ.  Gurgling sounds from RUQ.  Symptoms present with or without food.

What could this be?  Is there ever a non serious reason for a CBD to be this dilated?  Does this type of inflammation/dilation ever resolve on it's own?  Should they not have admitted me to rule out infection/cancer even without evidence of blockage and with normal bloodwork?  Have a follow up with GI but not able to see him for weeks.  Very sick feeling.  Incapacitated.
ER recommended MRCP.  Has anyone dealt with anything like this?  Is there reason for extreme concern?

[fntn]

Keep working with your doctor to get the final diagnosis. These types of biliary issues can get very complicated. I deal with many bile duct issues myself, include dilation, extrahepatic and intrahepatic. I can help answer any specific questions, but the trick is getting all the needed data to find out what's up ... MRI, MRCP, US, CT, Liver panels, endoscopy, etc.

Hope they track it all down for you soon and let us know how things are progressing.

[fntn]

forgot to say, definitely do the MRCP, this will provide valuable data ... especially coupled with the dynamic, contrast enhanced MRI.