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Stomach pain with CHOLELITHIASIS, CHOLEDOCHOLITHIASIS in CT.

Resolved Question:

Dear Doctor,

My sister aged 33 years was hospitalised a week back with severe stomach pain. In CT scan, it revealed that she has cholelithiasis and choledocholithiasis with stones of 8 mm and 4 mm and the consulting doctor advised immediate removal of the gallbladder (laparoscopy) and the operation is scheduled for today. We are not sure whether we should accept for this. I would like to have your urgent opinion whether we should accept the operation by the doctor.

For your kind information, my sister has SEIZURE SINCE BIRTH, and the last incident was in June 2014.

Copy of scan report and blood and urine reports are attached for your ready reference.

I shall be highly grateful if you will please give your advice on the scan report attached, and also the following:

1. Can the cholelithiasis and choledocholithiasis be treated by medicine?
2. How serious is the condition of both these as per the scan report?
3. Is removal of gall bladder (laparoscopy) only option for the above?
4. If gall bladder is removed, what after effects will it have on her body in the absence of the gallbladder?
5. Can we carry out the operation when she is a seizure patient?

AN URGENT REPLY IS REQUESTED SINCE OPERATION IS PLANNED TODAY AFTERNOON.

Thanking you,

P Pradeep Kumar
Coimbatore
South India
Mobile 98428 31340

Category: Gastroenterologist, Surgical

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Category: Gastroenterologist, Surgical
 24 Doctors Online

Hello,
Thank you for your medical query at DoctorSpring.com
I understand your concern and have reviewed your reports.
Yes, gallstones can be treated with medicines provided they are less than 5 mm, and there are not more than 2-3 small stones. There are medicines like choledeoxycholic and urosodeoxycholic acid tablets that can be taken.
But when a patient present with symptoms of cholelithiasis, surgery is the only modality, like in her case. She also has multiple stones, and her GB wall is thickened, so, this needs surgery. Your surgeon has given a good analysis and you should follow his suggestions.
She has to avoid too much fatty or spicy food, and apart from that there are no long term side effects of GB removal. It is becoming very common nowadays, due to the change in diet, hence, you should not worry. And yes, seizure is not a contraindication for the surgery.
Hope this was helpful,
Please update me following the surgery.
Regards.


Patient replied :

Dear Sir,
Good morning doctor!
The laparoscopy was conducted on 1/5/2015. Now we are informed that endoscopy has to be performed to remove the 4 mm stone. Kindly advise whether this procedure is required or will is pass on its own or can this be treated with medicine. Looking at her health condition and cost aspect involved, your suggestion in this regard will be highly appreciated.
Thanking you,

P Pradeep Kumar
Mobile: 98428 31340


Yes...endoscopic procedure is definitely required to remove 4mm cbd stone
It may pass on its own but patient may have complications. ..please go ahead with endoscopic procedure
Regards.


Patient replied :

Dear Doctor,
I refer the consult given for Consult ID CS050120150193.
The patient underwent removal of the gallbladder, but the stone that slipped was not removed and the doctor advised that it will go on its own. Now after more than 1-1/2 months, the patient is experiencing slight pain in the abdominal area and she has lost lot of weight. At the time of operation, she was 55 kg, but now she is only 43 kg and she feels very weak.
Actually, we are from a remote village and reporting to the doctor where we took treatment will take minimum of 2 days, and taking into consideration our hectic travel up and down, we would request your opinion with regard to the above and also suggest a remedy.
Thanking you.
P Pratheep Kumar
Mobile: 98428 31340


Hello,
Unfortunately, this consult is over a month old, and you have to initiate a new query to consult the same specialist.
Our consults are open for a month from the date of initiation or till 3 follow-ups have been utilised. This is nearly 2 months old now, so kindly initiate a new consult and we will request the same specialist to review this case.
Best Regards,
InHouse Physician.


Dr. Lokesh HM
Category: Gastroenterologist, Surgical
Experience: 
Fellowship: Minimal Access Surgery (FMAS)
Fellowship: Pancreato-Biliary surgery (FPBS), SGPGI Lucknow, 2012
Senior Residency: MCh, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI) Lucknow, 2011
Junior Residency: MS, PGIMER, Chandigarh, 2008
Medical School: MBBS, MS from Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, 2007
Dr. Lokesh HM and 4 other Medical Specialists are ready to help you

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