So, back from ERCP which was unsuccessful due to 'abnormal plumbing' (gastric bypass in 2008), so, went in the 'old fashioned' way, like a liver biopsy. Found a blockage in the main bile duct. First ever!
Bili in June, .8. Bili in August, 3.1 (reason for ERCP). Bili last week, 5.4.
Doc says "one possible reason for obstruction is bile duct cancer." WHAT?!?!?
CA19 normal, i.e., "no tumor markers" in June.
No fever, no major itching, stool loose but normal in color, no fatigue. Jaundiced eyes, slightly dark urine, lost 8 pounds in the last 3 months (but working out like crazy).
Can cancer grow that fast? Seriously a blockage tumor growing that big in two months?! What else could this be? Stone, bile, etc?
We go back for an MRI and surgeon consult (for removal of the obstruction) in a week. Is it okay to wait that long? Can I ask for another blood test in the meantime for another CA19 test to see if there's a tumor marker now? That's the fastest growing tumor I've ever heard of if it's a tumor, but I'm terrified!
Notes from June MRI:FINDINGS: Mild irregularity of the intrahepatic bile ducts consistent
with PSC. There is a focal dominant area of dilatation in the central
left lobe (series 15 image 177) and a long segment of narrowing
involving the common hepatic and proximal common bile duct. These
areas have minimal wall thickening and enhancement without definite
biliary mass. No definite findings to suggest cholangiocarcinoma.
Normal liver morphology. No hepatic masses. Nodes in the porta hepatis
are likely reactive in nature.
The pancreas and main pancreatic duct are normal. The splenic, portal
and hepatic veins are all patent. No ascites.
MR elastography demonstrates an average liver stiffness of 3.5 kPa
(range 3.4-3.5 kPa). Interpretation of MRE results suggest this value
to represent stage 2-3 fibrosis.
Small esophageal hiatal hernia. The abdomen is otherwise unremarkable.
.9NaCl, 2.50 milliliter
.9NaCl, 20.00 milliliter
