4mos of upper rt quad acute spasms under rt breast, ribs, back, mrcp & sono w/ dilated 9cm bile duct, lab work neg/no stones. If hida scan neg?
Possibly dyskinesia. Sometimes spasm at sphincter of oddi where common bile duct enters duodenum can occur with pain in right upper quadrant. Do not have stone or fixed obstruction. This diagnosis can be made sometimes on hida scan by looking at common bile duct and its response to cck. This is hard diagnosis to make. In addults with ERCP perfom manometrics as gold standard. Botox treatmentor stent have helped some.
Depends. I assume you mean 9 mm cbd not 9 cm. The hida seems a bit unnecessary at this point. If you have a dilated duct and normal liver tests, its prob not obstructed. If any further workup is performed, i'd go with an ercp.