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A 67-year-old female asked:

Bilirubin increasing with liver metastses . no bile duct blockage . all other liver tests are normal . what am this exactly mean ?

3 doctor answers5 doctors weighed in
Dr. Ed Friedlander
Pathology 45 years experience
Some ideas: If this is mostly direct bilirubin, some off the small bile ducts have been damaged. If mostly indirect, find a cause of hemolysis. If a mix, the loss of liver parenchyma is more severe than in most cases of metastatic disease. All are serious.
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Dr. John Michel
Family Medicine 47 years experience
Small bile duct: Although you say there is no bile duct blockage, this only means the major bile ducts. The smaller bile ducts are not able to drain as these are blocked by tumor. This is only early but as the tumor grows this may well be more progressive. If they are able to isolate the tumor in the liver, they may be able to ablate or embolize the tumor. Best wishes.
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Dr. Lewis Hassell
Pathology 40 years experience
Bilirubin: Elevated bilirubin can result from two main sources-- breakdown of hemoglobin (from red cells) and blockage of normal secretion from the liver (obstruction of a bile duct.) These two sources are distinguishable in blood (bound vs. unbound.) But liver mets may produce blockage of small ducts and elevate bili w/o blocking main ducts.
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Last updated Aug 25, 2015

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