A member asked:

I am having a pain where my gall bladder was removed. there is bile in my stomach and my bile duct is swollen. hida scan shows normal -what is this?

8 doctors weighed in across 3 answers

Postchole-x Syndrome: Postcholecystectomy syndrome is the persistence or return of RUQ abd pain following gallbladder removal. This is due to non-biliary causes (irritable bowel, ulcer dz, gerd, etc), organic biliary dz (common duct stones/stricture/cancer), or functional biliary disease (sphincter of oddi dysfunction). I advise GI work up to include labs, ultrasound+/-ercp, depending on above results.

Answered 8/20/2019


Dr. Gerald Mandell answered

Specializes in Nuclear Medicine

Duod-gastric reflux: Should have physician check report on hida scan for duodenogastric reflux. Some patients have duodenogastric reflux where bile goes from duodenum into stomach and causes gastritis can be seen sphinter of oddi dyskinesia is spasm of muscle where main bile duct enters duodenum. Can be prolonged spasm causing pain and soetimes associated with dg reflux. Careful interpretation of scan necessary.

Answered 4/26/2019



Sphincter of Oddi : Persistant pain in the GB area after removal is usually due to Sphincter of Oddi dysfunction. It occurs in about 6% of patients and requires ERCP with sphincter of Oddi manometry for proper diagnosis. If proven then the treatment would be Sphincterotomy which is opening the sphincter to allow the bile to flow freely into the duodenum.

Answered 4/26/2019



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