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What Causes Common Bile Duct To Be Prominent?

Posted on Wed, 12 Apr 2017

Question: My doctor sent me for an ultrasound due to chronic nausea and the only thing that showed up was a mildly prominent bile duct with no stones. Why do I still need a HIDA Scan....also my GFR has dropped to 55...so will the XXXXXXX they put in effect my kidneys at all? I have lupus

Answered by Dr. Dr. Ivan Romich (1 hour later)

Brief Answer:
no

Detailed Answer:
Hi,
First, HIDa scan uses isotope which is excreted through bile duct and small bowel and it doesnt affect kidneys function unlike CT contrast de which enters blood and is metabolized by kidneys.
SO HIDA can be done in your case.
Ultrasound will show possible stone or gallbladder changes but it cant detect gallbladder motility disorders so this may be a reason why your doctor ordered it, especially if there are no other causes of nausea. Wish you good health. Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Ivan Romich (19 hours later)

Is a 55 GFK low enough to start worrying about and follow-up or just keep watching.

Answered by Dr. Dr. Ivan Romich (3 hours later)

Brief Answer:
follow up consultation

Detailed Answer:
Hi,

This seems stage 3 of 5 and this is moderate kidney insufficiency and it can be managed with blood pressure regulation, dietary changes and medications if necessary. Also, blood sugar and body weight should be controlled.

You should reduce the salt intake. In future it is hard to predict will it progress to worsening function but in most cases dialysis is not required. It's extremely important that you stay under strict supervision of your doctor.

Let me know if I can assist you further.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Ivan Romich (6 hours later)

Thank-you for your detailed answers! I was diagnosed with lupus 20 years ago and am on plaquenil for that while treating symptoms only as they occur and flare-ups. Try to stay away from steroids as I have had internal bleeding from them in the past. I have had high blood pressure for many years and take lopressor 2x a day....Norvasc in the evening, 40mg of Lasix to get rid of excess water and Potassium to regulate the Lasix. With all those meds my blood pressure is now at a normal range but I have to keep taking the meds. Can any further damage be done to the kidneys if I am taking the meds? Also I have to monitor my salt intake or my eyes and feet swell up pretty bad. I am 5 foot 8 and weigh 138 lbs so weight is not an issue and luckily never has been and I try to stay away from almost all sugar as I have a history of Cancer on both sides of my family. My GFR had been borderline for the last ten years but over the last year has dropped from 75 to55 while taking all my meds and watching my salt intake. Is there anything I am missing? If all I need is to be under the supervision of a doctor to let me know when the GFR gets to a dANGEROUS LEVEL THEN i AM DOING THAT. sEE MY pRIMARY cARE EVERY THREE MONTHS. Just want to make sure I am not missing anything else that I could be doing.

Answered by Dr. Dr. Ivan Romich (19 hours later)

Brief Answer:
follow-up consultation

Detailed Answer:
Hi,

Well, I don't think that you are doing anything wrong and all you need is to continue with prescribed therapy and regulate blood pressure, blood sugar, and salt intake.

These medications don't have significant negative effect on kidneys. Chronic kidney insufficiency usually has slow but progressive course and you can't do much to influence it, except those measures that I've mentioned. You should also be careful with some antibiotics which may be nephrotoxic.

This is still acceptable GFR rate, Values under 20 are critical and may necessitate dialysis and you are far from this number so you don't have to be worried.

Regards

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Above answer was peer-reviewed by : Dr. Arnab Banerjee