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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 32786
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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in a blood test my bilirubin was raised to 18. can this be

Customer Question

in a blood test my bilirubin was raised to 18. can this be caused by gallstones
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Chip replied 2 years ago.
Hi--just to check here what are the units for that 18 number and was this total bilirubin? Where the other liver enzymes normal? And do you know if you have gallstones?
Customer: replied 2 years ago.

umol/L. this is total bilirubin according to results page I am looking at now.

ultrasound and ct were normal but still suffering bad rigors, chills, pain in upper right side and right shoulder. gp thinks its gallbladder related.

Expert:  Dr. Chip replied 2 years ago.
OK Most likely that was total bilirubin and if so it isn't very much elevated above high normal. What about direct and indirect bilirubin, alkaline phosphatase, SGOT and SGPT--the other components of the liver panel? And how long has this been going on? And are you actually running a fever?
Customer: replied 2 years ago.

alk phos 57U/L, GAMMA GT 24, ALT 14. total protein 75, albumin 47. That's all that's written under the heading liver profile. I was not that sick when these bloods were done but have had 15 lots of antibiotic doses since August 2013. rigors would resolve each time during antibiotic therapy but soon after would return. have chills and pain at night all of the time. When fevers come my temp is usually up about 40deg C. Infectious disease was ruled out and we are back to looking at gb again. gp says sometimes stones don't show on scans and I am finding this hard to believe.

Customer: replied 2 years ago.

Also I should say that white cell count and crp are huge during episodes. Sepsis is how one doctor on an emergency admission described what he was looking at.

Expert:  Dr. Chip replied 2 years ago.
OK. There can still be a problem with the gall bladder even without stones. It's called dyskinesia where the gall bladder doesn't empty properly and it takes a HIDA scan to look for that. I don't think your tests themselves prove or disprove that kind of gallbladder problem. That said, with the fevers you may also have an inflammed gallbladder and not just a poorly emptying one. So ask your doctor about the HIDA scan and if you do have dyskinesia, if you were my patient, I'd advise you to have your gall bladder removed
Dr. Chip and 2 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

I am fairly sure that the HIDA scan is not available in Ireland. Is it similar to an EUS scan?.

Expert:  Dr. Chip replied 2 years ago.
No, that's not the same and yes there are HIDA scans offered in Ireland and here's one example
http://www.stjames.ie/Departments/DepartmentsA-Z/N/NuclearMedicine/DepartmentinDepth/HIDA%20Scan.pdf
Customer: replied 2 years ago.

Thank You. Very happy with your information.

Expert:  Dr. Chip replied 2 years ago.
My pleasure but let me know how it goes for you
Customer: replied 2 years ago.

Dear Dr.

I should tell you that your advice on HIDA scan was excellent. It showed a problem with gallbladder but not stones. Before I got home from having scan done I was told I would need it removed urgently. I was admitted the following day to another hsp and surgery went well. Histology showed severe inflammation with several spots of sepsis. It was adhered to all organs around it and surgeon said it could have progressed to septicaemia if left any longer. Thank you.

During the process of all of this a murmur was detected in my heart and there was an echo ordered to assess it. Surgeon rang to say that I was not to worry but that I had a congenital Biscuspid aortic valve. He talked to a cardiologist who suggested an MRi. This was done on March 18th and went to cardiologist last Friday. He told me that the valve was biscuspid instead of tricuspid but was functioning well. Then he told me that I have a thoracic aortic aneurysm which will need to be dealt with along the way. I am devastated and not a little terrified because everything he said seemed so negative after that. Am I going to drop dead ?... My kids are still small.

Expert:  Dr. Chip replied 2 years ago.

Glad I could help with the gall bladder situation.

Since the aortic problem is an entirely new subject I'll be glad to discuss that with you but you need to open a new page with this link

http://www.justanswer.com/medical/expert-doctorchip

And on that page tell me all you can about the aneurism

Customer: replied 2 years ago.

The aneurysm is on the ascending aorta not reaching the aortic arch. It is measured 4.2cms. It is associated with Biscuspid valve condition. Not sure what all this means but hope it makes sense to you.

Expert:  Dr. Chip replied 2 years ago.
Thanks for that but you need to open another new page with the link I gave you since the last one disappeared