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338985 tn?1304314202

MRI Cholangiopancreatography...please help me as i need some answers on what to do here and im not well either

Hi.,.hope in right place..as need some answers..i have lost alot of weight lately,been tierd and dont eat much either and crave sweet things but not a diabetic.
I had a MRCP and the results were,no mass in gallbladder but dilated cbd 11mm in maximum calibre.It is dilated to its lower end,where a smooth tapering is seeen. The main pancreatic duct is also dialated,showing a calibre of up to 5mm in the pancreatic head. No dilation of the pancreatic duct side branches.No sinificant pancreatic parenchymal atophy seen.
The bile duct and main pancreatic duct s is dilated to the level of a Ampulla,.No mass identified on MRCP. ERCP correlation to rule out a small periampullary mass/lesion recommended/This radiological picturee may also be seen with sphincter of Oddi dysfunction.
So all in all that is the finding on the MRCP...can you please tell me what that means and am i going to be sort of ok and shoud  i go for the ERCP or is it recommended.
I have lost so much weight, am always tierd,cant eat right and last year i was diagnoised with chronic pancreatitis..so would that be all this really is..please can you help me with some answers as nothing is really happening and im not well..Thank you in Advance...Annemarie
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338985 tn?1304314202
sorry forgot to tell you i had blood tests done...Tumour Markers CA 19-9 are marginally raised....thanks...talk soon
Annemarie
Helpful - 0
338985 tn?1304314202
hi...just a heads up on what has happened thus far. I have all of the records and results i need. It seems i do have a tumour.....this is from my CT scan...but didnt show up on last years MRCP or in the ERCP because the surgeon didnt complete it with the dye.
Findings are...There is dilation of inta and extrahepatic bile ducts.The common bile duct is 10mm in diameter just above the pancreatic head..and it remains this size as it traverses the head with abrupt narrowing in the region of the papilla. The pancreatic duct is mildly dilated,measuring 4m in diameter in the pancreatic head and approx 2mm in the tail of the gland.
Comment...I don not have previous imaging for comparison,but I assume that an isodense stone in the lower end of the common bile duct has been excluded with  MR scan.
In this setting the possibilty of a tumour of the duodenal  papilla or at the distal end of the common bile duct becomes the most likely cause,an ERCP may be needed.....

That is it!!!! hard to understand but i doubt they will do another ERCP as they said they dont want to...also the ERCP i did have was never completed with the dye and that is why the tumour was missed...so not happy.
Hope your well and if you can shed any light on this for me...would be great.
take care
Annemarie
Helpful - 0
338985 tn?1304314202
Hi...and once again thankyou.
I rung the hospital today and explained things to the receptionist...she had a copy of what the dr found and said YES but couldnt say anymore as not allowed to....Some law.
So had to give them some ID...driviers licence and now have to wait 3 weeks for my file and results from that time....so its a matter of waiting to see those...But the lady at the hospital was soooo nice...spoke on the phone and she was kind, when i went in she personally took on my situation which is very unusal and normally you have to pay $30 for a copy and she didnt charge me a thing. So when i was speaking to her on the phone..she said yes when i asked her if i should go to brisbane...and if it was something needed checking but couldnt answer any futher about anything...so yes...I should be getting some thing from the hosp which is four hours away in the mail soon.
Gee my country in New Zealand got a tornado today...we NEVER get tornados in New Zealand until now....just waiting to hear if my family is ok....3 people were killed...so unusual all this weather going crazy...
thanks CalGal
Got to go we are having a wild storm atm
Annemarie
Helpful - 0
Avatar universal
Annemarie, I'm sorry to hear that you've been getting what appears to be a total run-around. It's unfortunate, but your area of the world is not the only place this sort of thing happens. I hope you're going to get some answers, and soon.

In the meantime, I'd like to suggest you get a copy of all of the written reports and the films (if any) and read through them. It could be important, and you need to have a better idea - personally - of what is actually going on.

Please keep in touch and let us know how you're doing.
Helpful - 0
338985 tn?1304314202
thank you for your help in my question,some time ago.
Wow'!!! what a roller coaster ride it has been. Okay this has been what has happened.
I had the ERCP and ended up in hospital for 4 days after, as i got Acute Pancreatitis, quite bad and my lipase were 9,780..thru the roof.
My GI at this hosp told me he gave me Pancreatitis.Mmm. I already have Chonic Pancreatitis anyhow but that was that. He said nothing was really wrong but he did NOT complete the proceedure at all and just said It should be ok. He also didnt put the dye in at all and I was sent home. I went to the GI in my area...He was 2 hours away...this GI in my area was concerned and wanted me to have another ERCP as this one wasnt completed propally.So I was sent to a Surgeon 4 hours away and drove all that way and the surgeon said to me,he is not doing anything,he said I have Pancreatitis and just to take pain relief and go to pain management. He also said even if he had something to support this in my bile duct that he wont be doing an ERCP or anything. I waited 2 months and went and saw the local Surgeon in my area and he wanted a Cat Scan and i went and drove an hour away and had one done. Its been a month and I had my appointment to see the local GI Specialist in my area again, he was a different Dr once again. Before I saw him the Nurse asked me if I had the CT Scan and where did I have it. They must of lost it, im not sure, but 2 hours later the Specialist called me in and sat me down and told me "You have to go down to Brisbane(4 hour drive again) and have another ERCP as there is a tumor in your common bile duct. Im like omg what? and he showed me the results and then he felt my tummy and said he will be contacting the GI Surgeon..the one that refused to do anything for me and if i had anything he still wont do anything and to just take pain pills. So I await probably a few months to get an appointment, and thats just to see him. Then from then anothr 3 months if he decides to do anything to get rid of my tumour. I cant guantee he will do anything because he said he will not....and I dont know why. He and his other leading hand dr both said it. So now there is proof but im still not convinced. I am now thinking that there is a mistake and I have gone from dilated bile duct to a tumour in bile duct. How does that happen in 10 months.Im very upset but im not sure I wont to travel all that way to be told they will do nothing., This is the public health in Australia, unfortunately people are mis-diagnoised alot and told to go home etc when they have in fact something wrong. Common occurrance.
When i told my mum i said "I think they are wrong actually, I will ring them tomorrow and tell them...Im sure they have the old results...
Sorry to go on and on. I havent spoken to anyone about all this...in detail.
I am sick of been sick. Sick of travelling and now the drs wont do anything where I have to travel to. The GI Specialists in my area have been pushing these Surgeons for nearly a year now. Still im sent back home.Im wondering why they didnt pick this up on the MRCP...they got the dilation...not this tumor part.
I dont know.
Thank you for answering my question the first time your the only one who did.
Annemarie
Helpful - 0
338985 tn?1304314202
Thank you for the people who answered my question...and at the moment that is one person and i thank you very much.
It is kind of making sense and guess i will just have to wait till i see my Gastro Dr on the 1st of Sept..and then i guess or maybe he will arrange for me to have an ERCP or maybe he wont...
I am very sick in the tummy all he time and i really am hating it.
I guess i am just going to wait and at least its not Cancer or anything.
But thank you for your answer and i hope they fix it very much soon.
Not too long till i see the Dr but then in Australia we have to wait more time before the Dr decides what he is going to do....so its a wait and see, and wait again..and wait more.
Thank you so much for answering my question...that is very nice of you,.
Have a very nice day.
Take care

Kiwi
Helpful - 0
Avatar universal
Kiwigal, only your GI doc is going to be able to give you a definitive answer when all the parts to the puzzle are put together. But what this is saying is you common bile duct is enlarged and in many cases that typically comes from gallstones that have at some point entered the duct and blocked it in some manner for a period of time. It can also happen when the sphincter of Oddi - the muscular opening to the duodenum - spasms shut and bile and pancreatic juices back up leading to dilation of the duct.

The main duct into the pancreas is also enlarged.

They're saying that both are dilated down to the point when they 'join' and enter the duodenum.

They were looking for 'something' in the duct (stones, or mass) that would account for the widening, but couldn't see anything. So they're saying an ERCP should be done to see if there's anything that can be seen visually, via ERCP, that could account for the widening.

However if ERCP is done, another step that should be done is the manometry - pressure reading step. If that's not done you will not know whether or not the pressures in the duct are raised which could be important in some form of diagnosis such as sphincter of Oddi dysfunction (SOD).
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