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Hi all

A couple of weeks ago, I had gone in for an ERCP to determine if I had PSC, but there was a twist in my bile duct, so the doctor was unable to finish off the procedure. What he ended up doing was making a cut in the twist, so he could go in at the end of the month to finish off the procedure. Then last week I had gone into the hospital because the area around my liver was feeling a little bit tender and I had a little bit of a fever, and I just wanted to make sure that there was nothing wrong, as I will be getting married next weekend and I didn't want to be sick for the wedding. During the testing, they said my liver enzymes had gone back to normal levels, from being four to five times their normal levels. Is this common? Of course, I may be grasping at straws hoping that I don't have PSC, but is it common to have twists in a bile duct which could have been causing a blockage and thus increasing my enzyme levels? And can just putting a cut in the bile duct reduce the enzyme level?

Terry

UC 90

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Hello Terry;

I've not heard of a " bile duct twist " before, but I could imagine that

if one occurred, it might block bile flow from the liver and result in

elevated serum liver enzyme levels. Bile duct ligation (creating a bile

duct blockage) in laboratory animals is often used to induce

cholestasis, and study the effects of cholestasis on liver

biochemistry, including elevated LFTs. So, if this " twist " was the

cause of your elevated LFTs and bile flow was restored by the surgical

procedure [but I'm not sure exactly how the " cut " would unblock the

twist ... you'll have to ask your surgeon to explain this], your LFTs

would tend to return to normal. Let's hope that this was the sole cause

of your elevated LFTs and that a subsequent ERCP does not show PSC.

Have a great wedding this weekend! Congratulations!

Best regards,

Dave

(father of (20); PSC 07/03; UC 08/03)

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wrote:

> I've not heard of a " bile duct twist " before, but I could imagine that

> if one occurred, it might block bile flow from the liver and result in

> elevated serum liver enzyme levels.

When I had an ERCP in 2001 (for PSC diagnosis and stent placement), the

drs. said my main duct was so severely sclerosed and fibrotic (due to

the PSC being already so far advanced) that it had become " corkscrewed "

thus making it impossible to get the stent in place. They immediately

sent me to MUSC and Dr, Cotton got the stent inserted.

Whether or not Terry's " bile duct twist " is the same as my " corkscrewed

duct " is debatable. Terry might simply have a torsion or some other

mild anomaly. I honestly hadn't even thought about whether the

" corkscrew " effect is typical or not. I would think, though that if you

haven't come across it in all your vast research, it must not be very

common.

Regards,

Carolyn B. in SC

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Terry

You got great questions. I have only 1 reply. PSC is a chronic disease. It flares and remits, so lab fluctuations are the norm. Congrads on the neptuals.

Bestjd, 45UC 1973, Jpouch 2000, Chronic Pouchitis 2001, PSC 2004, Stage 3Southern, ILkrmpotich@...

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So is it quite common for the results to change as listed below, with pre procedure blood tests and then post procedure blood tests

ALP 643 139

AST 137 21

GGT 547 108

ALT 156 37

By the way, the wedding was amazing, my wife (still sounds weird saying it), has never looked so beautiful. With her kidney disease and my potential liver disease, I think we were the only two sober people there. But it was still fun.

Terry

UC 90

Re: Liver enzymes

Terry

You got great questions. I have only 1 reply. PSC is a chronic disease. It flares and remits, so lab fluctuations are the norm. Congrads on the neptuals.

Bestjd, 45UC 1973, Jpouch 2000, Chronic Pouchitis 2001, PSC 2004, Stage 3Southern, ILkrmpotich@...

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Congratulations on your wedding!!!LeeSo is it quite common for the results to change as listed below, with pre procedure blood tests and then post procedure blood tests ALP    643    139AST    137    21GGT    547    108ALT    156    37 By the way, the wedding was amazing, my wife (still sounds weird saying it), has never looked so beautiful. With her kidney disease and my potential liver disease, I think we were the only two sober people there. But it was still fun. TerryUC 90

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Which procedure? An ERCP with balloon dilatation and stenting might account for it.

Arne54 - UC 9/77 - PSC 4/00Alive and (mostly) well in Minnesota

From: [mailto: ] On Behalf Of Terry Craig

So is it quite common for the results to change as listed below, with pre procedure blood tests and then post procedure blood tests

ALP 643 139

AST 137 21

GGT 547 108

ALT 156 37

By the way, the wedding was amazing, my wife (still sounds weird saying it), has never looked so beautiful. With her kidney disease and my potential liver disease, I think we were the only two sober people there. But it was still fun.

Terry

UC 90

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The doctor had put a cut into the bile duct because he was unable to complete the ERCP due to a twist in the bile duct. The cut was being done to straighten out the bile duct. It was after putting this cut in that the liver enzymes went down. He will be completing the ERCP on the 29th.

Terry

UC 00

RE: Liver enzymes

Which procedure? An ERCP with balloon dilatation and stenting might account for it.

Arne54 - UC 9/77 - PSC 4/00Alive and (mostly) well in Minnesota

From: [mailto: ] On Behalf Of Terry Craig

So is it quite common for the results to change as listed below, with pre procedure blood tests and then post procedure blood tests

ALP 643 139

AST 137 21

GGT 547 108

ALT 156 37

By the way, the wedding was amazing, my wife (still sounds weird saying it), has never looked so beautiful. With her kidney disease and my potential liver disease, I think we were the only two sober people there. But it was still fun.

Terry

UC 90

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Terry

Yep. Mine have looked very similar over the past year and that is without any special measures such as experimental drugs. If those on the right hand side are more recent, at least your headed in a positive direction. (me too). Certainly know the bride beauty experience. My bride was the same. it's been 10 years and we "dated" for about 5 before that. On the big day I was so taken by her radiance that I choked back a flood of tears through a significant part of the nuptials. I thought that by then I'd seen her at her best (and worst), but alas, I was wrong. Sort of like love, just when you think you have arrived, it deepens. Enjoy married life. It's the best.

Bestjd, 45UC 1973, Jpouch 2000, Chronic Pouchitis 2001, PSC 2004, Stage 3Southern, ILkrmpotich@...

Re: Liver enzymes

Terry

You got great questions. I have only 1 reply. PSC is a chronic disease. It flares and remits, so lab fluctuations are the norm. Congrads on the neptuals.

Bestjd, 45UC 1973, Jpouch 2000, Chronic Pouchitis 2001, PSC 2004, Stage 3Southern, ILkrmpotich@...

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