Question for the medical professionals

Discussion in 'The Okie Corral' started by Mrs. VR, Oct 19, 2010.

  1. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    What kind of things can cause a dilated pancreatic duct and a dilated common bile duct in a pediatric patient?
     
  2. ExxoticOne

    ExxoticOne

    Messages:
    16,857
    Likes Received:
    16
    Joined:
    Sep 18, 2002
    Location:
    Belleair Beach, FL & Houston, TX
    Does the child have chronic pancreatitis?
     

  3. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    not that's been diagnosed. Only symptoms are elevated liver enzymes, abdominal pains that come and go, occasional nausea/vomiting and a rash on the arms.
     
  4. ExxoticOne

    ExxoticOne

    Messages:
    16,857
    Likes Received:
    16
    Joined:
    Sep 18, 2002
    Location:
    Belleair Beach, FL & Houston, TX
  5. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    nope, and a previous liver biopsy was normal, but that was before the pancreatic duct became enlarged.
     
  6. kcb

    kcb Southern Lady

    Messages:
    14,751
    Likes Received:
    248
    Joined:
    May 20, 2005
    Location:
    God's BEAUTIFUL World
    Not a doctor.

    Are the whites of the eyes yellow? Skin yellow or look tan?

    If so, call the doctor!
     
  7. ExxoticOne

    ExxoticOne

    Messages:
    16,857
    Likes Received:
    16
    Joined:
    Sep 18, 2002
    Location:
    Belleair Beach, FL & Houston, TX
    Google choledochal cysts.
     
  8. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    that's where we thought it was going last time. Probably having an ERCP.
     
  9. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    FTR, I asked here because google is nauseating.
     
  10. ExxoticOne

    ExxoticOne

    Messages:
    16,857
    Likes Received:
    16
    Joined:
    Sep 18, 2002
    Location:
    Belleair Beach, FL & Houston, TX
  11. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    had one last year.
     
  12. Jerry Smith

    Jerry Smith Sleep Deprived

    Messages:
    435
    Likes Received:
    0
    Joined:
    Mar 23, 2005
    Location:
    Lexington, KY
    Age/sex/ethnicity of patient?

    this could be a simple gallstone, or perhaps a cyst but there are several other POSSIBLE diagnoses (systemic illness, acalculous cholecystitis, pancreatic involvement, biliary dyskinesia, congenital problems {cystic and hepatic fibrosis, etc}.

    Does the patient have any other known medical problems? ie known congenital abnormality, premature birth, other known liver problems, acid reflux issues, hernias, cardiac problems?

    Does the patient take any medicine daily? Or possibly have had antibiotics recently?

    What was the bili and alk phos level? Amylase/lipase level? These will paint a picture of where a stone may have lodged (if there is a stone)

    Im sure your answers to some of the above q's will lead me to MORE questions. Secondly, if you've already been seeing someone, and they've done a liver biopsy, they probably have a strong working diagnosis by now..... i assume fibrosis crossed their mind when they did the biopsy.
     
    Last edited: Oct 19, 2010
  13. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    7 year old white male, history of GERD, takes previcid daily. Endoscopy and colonoscopy last spring only showed some inflammation in the duodonum. Don't have labs in front of me, but the only thing of interest has been mildly elevated ALT and AST. Being seen by the chief of the pediatric liver center at Hopkins, but she's not sure either. She probably just got the latest results this afternoon, so we'll talk to her tomorrow, but I wanted to have my ducks in a row. Before latest ultrasound she said that if the CBD was still dilated she wanted to do an ERCP and probably another liver biopsy.
     
  14. SheepleNoMore

    SheepleNoMore

    Messages:
    2,515
    Likes Received:
    0
    Joined:
    Dec 26, 2007
    Location:
    Mid America
    At first I thought you were running a replay of last night's episode of House. Then I finished reading and realized you weren't. Sorry to hear it's for real. Best of luck.
     
  15. ExxoticOne

    ExxoticOne

    Messages:
    16,857
    Likes Received:
    16
    Joined:
    Sep 18, 2002
    Location:
    Belleair Beach, FL & Houston, TX
    CD/DH been ruled out?
     
  16. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    CD being Crohn's? I am so exhausted, I can't figure out the acronym even though I know I should know what they are.
     
  17. ExxoticOne

    ExxoticOne

    Messages:
    16,857
    Likes Received:
    16
    Joined:
    Sep 18, 2002
    Location:
    Belleair Beach, FL & Houston, TX
    Celiac Disease and Dermititis Herpetiformis.
     
  18. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    ah. I am pretty sure they took samples for celiac when he was under last time, but I'd have to double check. Not sure about the other. I will look over all our notes again in the morning before I talk to the doc at Hopkins. Our local pediatrician was very honest and said "I have no idea what it means".
     
  19. ExxoticOne

    ExxoticOne

    Messages:
    16,857
    Likes Received:
    16
    Joined:
    Sep 18, 2002
    Location:
    Belleair Beach, FL & Houston, TX
    The DH may account for the rash...prevalent in males too.
     
  20. Mrs. VR

    Mrs. VR Sharon, you will be missed.

    Messages:
    26,373
    Likes Received:
    962
    Joined:
    May 18, 2004
    Location:
    On the way to crazy
    Just googled the DH, and I don't THINK that's what the rash looks like, it's just small open sores on the arms, but I'll definitely mention it again to the docs. It doesn't generally itch.