A 43-year-old female 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?
3 doctor answers

Dr. Barry Rosen answered
34 years experience General Surgery
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 on Aug 20, 2019
1
1 thank

Dr. Gerald Mandell answered
52 years experience 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 on Apr 26, 2019
1
1 thank

Dr. Abdelkader Hawasli answered
43 years experience General Surgery
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 on Apr 26, 2019
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