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Ask Dr. David Your Own Question

Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 44356
Experience:  Board Certified Physician
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Would an MRCP of the biliary system detect liver disease?

Customer Question

Would an MRCP of the biliary system detect liver disease?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

MRCP can detect dilation of the biliary system.

Dr. David :

and problems in parts of the liver.

Dr. David :

but you also need blood liver enzyme testing

Dr. David :

and sometimes a liver biopsy to know for sure.

Dr. David :

what liver disease are you worried about?

Customer: I had both an ultrasound and mri, liver was normal on both. Ultrasound showed gallbladder sludge. Lfts normal apart from raised ALP at 140
Dr. David :

alk phos can be elevated for many reasons.

Dr. David :

have you had a bone scan?

Dr. David :

how old are you?

Customer: 34, my symptoms were ache under right shoulder blade radiating to right side of chest with nausea.
Customer: is it likely with these results that this could be some sort of liver damage?
Dr. David :

no, unlikely to be from liver damage.

Dr. David :

normal alk phos is between 20-140

Customer: So what could this be?
Dr. David :

so some normal ranges for alk phos is is 44 to 147 IU/L

Dr. David :

so 140 isn't really elevated.

Customer: What could be causing my symptoms?
Dr. David :

it could be from acid reflux and inflammation of your esophagus.

Dr. David :

do you have a history of acid reflux?

Customer: A little. The nausea is worst after eating and the most bothersome symptom is the pain under right shoulder blade and in the right shoulder itself
Dr. David :

you could be having irritation of your right diaphgram after eating with distention of your stomach

Dr. David :

which could be pressing up on your diaphram and causing right shoulder pain

Dr. David :

any sort of irritation of the diaphgram can cause referred shoulder pain.

Dr. David :

you need a chest xray

Dr. David :

and a chest CT scan

Dr. David :

to look for any pleural fluid and to look for any sort of irritation of the right hemidiaphram.

Customer: My consultant thought this was my gallbladder and advised removal of the gallbladder? When the pain is intense the area under my right ribcage is tender to the touch. This all become worse a couple of months after giving birth to my son
Dr. David :

it could very well be due to your gall bladder which is under your right rib cage.

Dr. David :

an ultrasound of your gall bladder can tell if your gall bladder is inflamed and enlarged.

Dr. David :

your gall bladder is also put to work when you eat a big meal.

Dr. David :

have you had a gall bladder ultrasound yet?

Dr. David :

I would do this first before an MRCP

Customer: The ultrasound just showed sludge in the gallbladder
Customer: I have had both ultrasound and mri of biliary system, liver and pancreaas
Dr. David :

I see.

Dr. David :

you can get a HIDA scan which can show functionality of your gall bladder.

Dr. David :

and ejection fraction of your gall bladder to see if it is working properly.

Dr. David :

if the gall bladder is not working properly, then that could be the problem and causing a backup when you eat

Dr. David :

and inflammation and irritation of the diaphram and right shoulder pain.

Dr. David :

I would ask your doctor to get a gall bladder HIDA scan.

Customer: Would the sludge be suggestive of this?
Dr. David :

sludge in the gall bladder is very common

Dr. David :

and doesn't mean it is not working properly.

Dr. David :

a HIDA scan will show if the gall bladder is doing what it should be doing.

Dr. David :

which is ejecting bile into your small bowel.

Customer: So sludge wouldn't cause the symptoms I have?
Dr. David :

sludge is very common.

Dr. David :

and is not specific for your gall bladder not working.

Dr. David :

you need a HIDA scan

Dr. David :

and also a chest xray or chest CT scan to check for fluid outside of your right lung.

Customer: But could sludge cause the right shoulder blade pain etc?
Dr. David :

so sludge may or may not be part of the problem.

Dr. David :

it is not enough information yet.

Dr. David :

have you had a chest xray or chest CT scan?

Customer: No, my consultant told me that sludge can cause the same symptoms as gallbladder disease? Is this correct?
Customer: Also, I am not sure if you have heard of a gallbladder flush? I did one of these and I passed lots of different sized green stones?
Dr. David :

problem with gall bladder flush is that sludge comes back.

Dr. David :

sludge is just thick bile seen in the gall bladder.

Dr. David :

most people have gall bladder sludge.

Dr. David :

sludge is thick bile and sediment in the gall bladder.

Dr. David :

many people have this in their gall bladder.

Dr. David :

most people don't have to have their gall bladder removed because of this.

Customer: That's what I thought as I did it once, felt great for 8 weeks then the symptoms came back. The last time I did it, these green stones came out, what are they?
Dr. David :

thick bile, cholesterol all mixed together so thick they become solid.

Customer: So is this essentially the sludge from the gallbladder that has come out?
Dr. David :

if the sludge is causing gall bladder dysfunction, and pain symptoms then the gall bladder has to be removed.

Customer: I'm asking if what I passed after the gallbladder flush is gallbladder sludge or gallstones?
Dr. David :

probably both.

Customer: Do gallstones look green? Final question what liver problems would an ultrasound and mri show
Dr. David :

yes, gall stones can look green.

Dr. David :

it would show inflammation of the liver,

Dr. David :

or fatty replacement of the liver.

Dr. David :

or dilated bile ducts.

Customer: What about cirrhosis
Dr. David :

yes, a liver ultrasound or MRI scan would show cirrhosis.

Dr. David :

which is advanced fatty replacement of the liver.

Dr. David :

let me know if you have other questions.

if done for now, please leave positive rating below the chat box so I can get credit for helping you today

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Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 44356
Experience: Board Certified Physician
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