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Cholangiogram: Percutaneous means through the skin. Cholangiogram means they are putting a contrast into the billiary tree/ ducts to check for obstruction.Definition: an x-ray film of the bile ducts produced after injection of a radiopaque contrast medium. A cholangiogram is routinely performed before or after biliary tract surgery. A postoperative radiogram may be made after injecting an iodinated contrast. ...Read moreSee 1 more doctor answer
Retained Stones: In the era prior to ercps, stones that left the gallbladder and entered into the common bile duct (cbd) had to be surgically removed by opening the cbd. At the end of the cbd exploration, a t-shaped tube is placed into the bile duct to prevent bile leakage from the duct and to allow a portal of entry into the cbd to retrieve any cbd stones left behind. The t-tube 'gram searches for these stones. ...Read more
I had my gallbladder removed & cholangiogram. It showed minimal mucosal irregularity of cbd due to inflammation. GB had mucosal fibrosis.Advice?
Asked your surgeon?: Have you asked your surgeon about it? Are you having any symptoms? Usually people with those findings get better after GB removal, but if you are still having problems, you need to talk to your surgeon about it. Sometimes a surgical complication can cause continued or delayed symptoms. ...Read more
36 year old with cholestasis of pregnancy during 2nd pregnancy. 6 months after delivery liver enzymes were still elevated, but GB been removed.....?
Unexplained weight loss: Assessment and Plan: 36 yo woman G2P2 with PMH sig for intrahepatic cholestasis of pregnancy, cholecystitis, s/p cholycystecomy presents with unexplained weight loss, elevated transaminases of unknown level >6 mo,polyarthralgia, fatigue,nausea, and dysmenorrhea. You need to be referred to multiple specialists for evaluation of your medical problems. 1. Gastroenterology/Hepatology- CT/MRI scan of liver indicated ,repeat ERCP if indicated. Consider liver biopsy since liver enzymes elevated >6 months. Evaluate all meds, alcohol use, family history of hemochromatosis, NASH. Serology for TSH, Iron, Ferritin, TIBC, alpha-1 antitrypsin, liver function, Hepatitis serologies, ANA, H. Pylori test, and other labs as indicated. 2. OB/GYN- Your painful periods/ dysmenorrhea can be best evaluated by a OB/GYN specialist. 3. Internal Medicine-workup other causes wt. loss, fatigue, joint pain based on med history/ meds. These referrals should be a good start. Good luck. ...Read moreSee 9 more doctor answers
27 yr-old woman with 2 yrs of bad intermittent epigastric pain, persisting after cholecystectomy, without a clear diagnosis, after evaluation.....?
Bile duct stone?: There are a number of tests, ultrasound, mrcp that you could have to rule out a retained or new primary gallstone in your bile ducts. If these are clear an EGD/ERCP may help. IF negative you may need additional testing. Reflux, gastritis, ulcers , pancreatitis Many things can cause right sided pain. See a surgeon or GI doc ...Read moreSee 9 more doctor answers
Bile Duct X-ray: A cholangiogram is an x-ray of the bile duct utilizing an injection of dye in order to look for abnormalities such as bile duct stones, strictures, tumors, etc. The injection may be performed by a surgeon at the time of gallbladder surgery, by a gastroenterologist at the time of an ercp, or by a radiologist, by using ct- or ultrasound guidance, to inject through the liver. ...Read more
No, but...: There are less invasive ways to image the biliary tree, like ultrasound, ERCP (by a gastroenterologist) and mrcp (mri). If there is some blockage, drainage can usually be achieved by a gastroenterologist, with percutaneous drainage reserved for cases that cannot be treated by a gastroenterologist. While percutaneous biliary imaging and interventions do not have high risk, less risky options exist. ...Read more
Before I have cholecystectomy, do I have to ask my surgeon to do intra-operative cholangiography, or is this standard procedure during surgery?
Yes, ask: There is still substantial debate whether intraoperative cholangiography (ioc) should be routine or selective. There are clear indications for ioc, such as having elevated bilirubin and common bile duct stone on ultrasound - while having a history of gallstone pancreatitis is a relative indication. If a stone is seen on ioc, some surgeons are facile in removing them, otherwise endoscopic removal. ...Read moreSee 1 more doctor answer
If my surgeon sees a stone in the pancreatic duct or common bile duct during intra-operative cholangiography, can he remove the stone during surgery?
IV?: IV lidocaine may correct temporally an abnormal cardiac rhythm but is not long term therapy. In general patients don't feel anything in particular but be wary if you feel numbness of the tongue/lips and ringing in the ears. That's a sign the lido level is high. If this is epidural, spinal or isolated nerve block there will be a reduction of pain and weakness of the involved nerve. ...Read more
It depends: It depends on the medicine injected and the history of the patient. ...Read more
I wanna administer epinephrine orally, not intravenous, but which quantity do you recommend me to get? I would prefer obtaining a minimum effect.
Okay, but...: There is no reason what no to do VCUG with iodine contrast. It is a common practice to do retrograde pyelogram (injecting iodine contrast to ureter ; kidney through a tube in cystoscope). So it's okay to do VCUG as long as not done at the time having active infection and inflammation. For detail? Ask radiologist. But note: few radiologist would not take any responsibility just like few patients. ...Read more
Definitely: Iv drug users are much more likely to get endocarditis, a life-threatening infection of heart valves that is difficult to treat. Skin bacteria enter the bloodstream during injection and attach to the valves, especially on the right side of the heart where blood enters from the body. The staph on the skin are particularly dangerous endocarditis organisms to which IV users are susceptible. ...Read moreSee 1 more doctor answer
IV Lidocaine: Lidocaine, in low doses, is actually injected intravenously in certain clinical situations. Toxic levels of this medication would first cause neurologic symptoms and then cardiovascular sequelae. If small amounts are injected IV in the process of infiltrating tissue, it is unlikely that one would suffer any major complications. ...Read more
Can past drug use (I.e. intravenously) cause permanent low sperm count Even if you have been sober for a number of years?
Not likely, unless..: For average men, the expected drug effect onto spermatogenesis should fade since body has its strong inherent self-healing and remodeling ability. Besides, do not worry about something unknown or uncertain beyond your control, but focus on what you can do now. To delve into more life reality, go to http://formefirst.com/MustReadNotes.html & http://formefirst.com/Basics-SelfImprovement.html. Best.. ...Read moreSee 1 more doctor answer
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