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1/25/2018 7:38:29 AM
Posted: 7/12/2002 9:41:12 PM EST
[Last Edit: 7/12/2002 9:56:46 PM EST by TheKill]
My father in law just left. He just put my mother in law in the hospital with acute gallstones. She is doing ok, but my father in law had a lot of questions that he could not seem to get answers to. 1. They ran a battery of tests on her, among them were ultrasound. They said she has 3 stones in her gallbladder, and one that is in a duct, that one is trouble I guess. 2. In the morning they are sending her via ambulance to the "big city" hospital, for some other test or procedure, but my father in law could not make sense of exactly what nor get any straight answers from her Dr. Supposedly she is then coming back to our local hospital for treatment. My uneducated opinion is that they are sending her out for MRI or CT scan to check for possible tumors, hence the tight lipped attitude with the Doc (my father in law is a big man and very gruff). I guess what I am looking for is info on what gallstones really are, what are the procedures used to diagnose the condition (to help clear up what the tests are all about) and what is the course of treatment and prognosis. Thanks in advance. Edited cause I know we have docs and medics here...
Link Posted: 7/12/2002 9:45:12 PM EST
Link Posted: 7/12/2002 9:58:40 PM EST
Thanks DoubleFeed. I didn't think Gallstones were that big of a deal, but between her being immediately hospitalized, and going to the big hospital for more tests tomorrow, we are all kinda nervous. My mom in law is great, and my father in law is my big hunting and drinking buddy, they live right down the road.
Link Posted: 7/12/2002 10:10:06 PM EST
Link Posted: 7/12/2002 10:26:40 PM EST
a stone in the duct can cause the gallbaldder to actually die and become necrotic..at the very least it is a horribly painfull illness. the majority of gallbladders are removed with very few complications.. and the person can usually go back to light duty within just a few days.. on the other hand if the gallbladder has become infected ..or actually ruptured( a stone in the commom bile duct can cause the gallbladder to fill to the bursting point with bile and pus )the person can be in for a very long and difficult recovery..kinda like an appendix rupturing..peritonitis... if they are sending herout to another hospital it may be for more tests..ultrasound or maybe a quick ct scan but more likely they are sending her out for surgery at a facility better suited to handle her case... let us know how she does.. i do them all the time and see patients go home the day after surgery most of the time.. john in houston
Link Posted: 7/12/2002 11:27:17 PM EST
At least the malady doesn't sound like it should be a life threatening deal, that is cool. Thank you John!
Link Posted: 7/13/2002 3:19:28 AM EST
[Last Edit: 7/13/2002 3:22:39 AM EST by noah]
I had acute cholecystitis in '88. A pea-sized stone lodged in the common bile duct. The month of April I didn't feel "right", but I didn't feel sick. Never a bile-barf attack or any pain. On 8 May I got a high fever and chills like flu, no aches. 9 May the Dr. stood in the door of the exam room and she told me I had a "hot" gall bladder (infected) just by looking at my vitals and yellow eyes, even without an exam. I was admitted for tests and to stay on IV antibiotics. It came out on 11 May the old fashioned way (endoscope wasn't ready yet and they couldn't do it on a hot one anyway). During the procedure the surgeon was lifting it out and it burst. He told me later that it was 2X normal size and black as coal inside, and if it had gone another 12 to 24 hours I would have clocked out. I spent a total of 8 days in the hospital on the IV antibiotics, and today have a 4-inch scar under my right ribs to show for it. My guess is that they sent your MIL to the other hospital to run a nuclear medicine scintillation counter test in which a very short half-life radioisotope is injected in the blood and you lie still under a large round detector (80's technology, maybe it's different now). The device can measure blood circulation in organs, and they are looking for necrosis in her GB. Your local hospital may not have capability. If the GB is necrotic, they can't do the endoscope procedure because infection would spread as they slice up the GB for removal throught the tube, and instead she gets the 4" scar and a longer recovery. My GB was "dead", per the radiologist -- no uptake of the radioactive agent, and they started sharpening the knives. My prayers and best of luck! Noah
Link Posted: 7/13/2002 3:44:54 AM EST
Most likely they'll have to run a scope to get the stone unlodged. Then she will have to have her gallbladder removed. Both are relatively simple procedures that shouldn't take more than an hour or 2 each.
Link Posted: 7/13/2002 3:54:59 AM EST
My wife had her gallbladder removed about 6 months ago. They did outpatient surgery in about 2 hours and she was home. She went shopping the next morning. She did'nt have much pain and she has 3 very small scars. Good luck.
Link Posted: 7/13/2002 9:14:03 AM EST
[url]http://www.surgical-tutor.org.uk/default-home.htm?system/abdomen/gallstones.htm~right[/url]
Link Posted: 7/13/2002 12:42:51 PM EST
[Last Edit: 7/13/2002 12:44:01 PM EST by Gunner1X]
Prayers going out. I passed a kidney stone a few years back, not my idea of a good time. My sympathies, and I know she'll be fine.[;)]
Link Posted: 7/13/2002 6:29:14 PM EST
Well, apparently they don't do endoscopy here because they are doing construction. She went to the other hospital and they did endoscopy, they removed 15 gallstones. They also put in something called a stent. She is scheduled for surgery Monday. She is feeling better and doing OK. Hopefully Tuesday she'll be out and it'll be over with. Thanks guys.
Link Posted: 7/13/2002 8:22:48 PM EST
I'll try to answer some of your questions. 1. Gallstones are most commonly made of a. cholesterol, b. bilirubin and c. mixed stones. No one is really sure why some people make stones and others don't. The theory is that cholesterol stones occur due to a supersaturation of cholesterol in bile. However, this doesn't have any thing to do with your blood cholesterol. 2. Ultrasound is the gold standard test to diagnose gallstones. CT and plain x-rays will only pick up 15-20% of stones. 3. Your mother in law has a common duct stone, which is a condition called choledocholithiasis. Obstruction of the common duct can cause jaundice, pain, and severe nausea/vomiting. 4. It sounds like she will have an ERCP (endoscopic retrograde cholangiopancreatography) at the bigger hospital. This is where a GI doctor will pass a lighted scope down into the small intestine and visualize the opening where the common duct emptys into the small intestine. He will then pass a catheter and retrieve the stone this way. ERCP is 90-95% successful in retrieving the common duct stone. 5. She will ultimately need a gallbladder surgery. 90-95% of cholecystectomies are done laparoscopically (with a camera through 4-5 small incisions). However, if the GI doc is unable to retrieve the stone with ERCP, she will need an open cholecystectomy through a larger incision and the stone can be taken out of the common duct during the open surgery. Hope some of this helps. I have operated on two people in the past 3 days that have had common duct stones. Both will have ERCP.
Link Posted: 7/13/2002 11:16:20 PM EST
I’m neither a doc nor a medic, but I know a little about gallstones since I had them several years ago (and I can eagerly attest to the pain caused by an attack – it feels like you’ve been shot in the stomach with a 9MM!). My doctor intended to remove my gall bladder laproscopically (though I was warned of possible complications). The nurse told me I’d just have a few band-aides on my tummy and stay overnight. Not so! Turns out the doctor had trouble getting “visualization” with his instruments and ultimately just cut me open (8 inch scar - I accused him of using a chain saw on me!). I was in surgery for maybe 4 hours, the hospital for 5 days, and was off work for the better part of a month. All that being said, everything worked out OK. Incidentally, the doctor or the hospital should have a pamphlet they can give you explaining some of these issues. Wish her luck!
Link Posted: 7/14/2002 1:10:03 AM EST
Originally Posted By 199: Incidentally, the doctor or the hospital should have a pamphlet they can give you explaining some of these issues.
View Quote
I have a standard 'spiel' that I go through with each patient when explaining gallbladder surgery. I think it is important to discuss all of the risks involved with the procedure with the patient. Unfortunately, converting to an open procedure is always a risk when attempting a laparoscopic procedure.
Link Posted: 7/14/2002 4:39:16 AM EST
this may be hard to do............, but !!! my mother had her gall bladder removed about 1950ad, the doc missed one lyttle stone, in 1980ad she started to get symptoms of jaundice, a doctor who was NOT her regular doctor said "lets do some exploratory surgery"........, my mother was killed for no reason at all because her regular doc said it was not of an urgent nature... [B]MAKE CERTAIN SHE HAS A COMPETENT DOCTOR !!!!![/B]
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