hilary1617
First time at the rodeo.
- Joined
- Jan 6, 2014
- Messages
- 3,874
Hello,
Is it possible that the hepatosplenomegaly is a side effect of Sphincter of Oddi Dysfunction (SOD)? I don't see them linked in internet searches, but would that make sense?
I have suspected that I have SOD since that thread where Kirmy was having pain and SOD was mentioned because the symptoms sounded so similar to what I experience. I have had frequent bouts of bend-in-half postprandial right upper quadrant pain for the past year. I had been using opiates to treat it and found the pain is actually far better, even absent more often than not when I don't take them.
The pain commenced following a cancer surgery which also involved a cholecystectomy (conducted about 8 months post-DS). My gallbladder measured 8 cm at the time it was removed though it was supposedly visualized during my DS with normal appearance, so the enlargement happened post-DS. I have had bile salt diarrhea since its removal, treated by Welchol.
Last week, I had MRI, CT with and without contrast, and Octreoscans to see if the cancer returned/spread. However, I won't see my oncology team to review the results until April 23 (because my oncology blood work takes 4-5 weeks to process).
I have received copies of the radiologist's reports and I am wondering if the reports are consistent with SOD. The salient study result details read: "The liver demonstrates no mass but is enlarged. Gallbladder is now absent. There is no significant lymphadenopathy in the porta hepatis region. Common duct is not enlarged. The spleen is normal in density however is enlarged." This is summarized at the end of the report as "Moderate hepato-splenomegaly".
I had previously been experiencing ascites, which now appears to be resolved as is not noted in the scans. (This coincides with my abdomen looks a bit less pregnant now than it had been looking, though it still sticks out quite a bit, presumably from the hepatosplenomegaly). I had protein malnutrition and have been working hard to improve my levels (Creon and tons of protein). The CBC and comprehensive panel showed everything as normal except Albumin of 3.4 (Low - normal is 3.5-5.2 g/dL) and anion gap of 6 (Low - normal is 8-16 mmol/L). Granted most of my numbers are on the low side of normal - there is definitely an upward trend and this is the first time that many have shown up in the normal range this year.
Bottom line, if my protein situation is coming under control enough to relieve the ascites completely, but my liver and spleen are still angry and inflamed (over a year since my last surgery!), is it possible that SOD is the cause? Could it also be linked to the bile salt diarrhea? Or am I just so desperate to see a pattern that I am connecting the wrong dots?
Please let me know your thoughts! It's going to be a long five weeks wait to discuss these results with my doctors!
Thanks,
Hilary
P.S. On a side note, good news on the cancer front. My pancreas remnant is unremarkable other than missing its tail and associated tumor - nothing is noted there other than the resection. If there are metastases they would have to be small enough not to be picked up on CT or MRI. (Though I haven't gotten the Octreoscan results yet, which is what would make them light up...)
Is it possible that the hepatosplenomegaly is a side effect of Sphincter of Oddi Dysfunction (SOD)? I don't see them linked in internet searches, but would that make sense?
I have suspected that I have SOD since that thread where Kirmy was having pain and SOD was mentioned because the symptoms sounded so similar to what I experience. I have had frequent bouts of bend-in-half postprandial right upper quadrant pain for the past year. I had been using opiates to treat it and found the pain is actually far better, even absent more often than not when I don't take them.
The pain commenced following a cancer surgery which also involved a cholecystectomy (conducted about 8 months post-DS). My gallbladder measured 8 cm at the time it was removed though it was supposedly visualized during my DS with normal appearance, so the enlargement happened post-DS. I have had bile salt diarrhea since its removal, treated by Welchol.
Last week, I had MRI, CT with and without contrast, and Octreoscans to see if the cancer returned/spread. However, I won't see my oncology team to review the results until April 23 (because my oncology blood work takes 4-5 weeks to process).
I have received copies of the radiologist's reports and I am wondering if the reports are consistent with SOD. The salient study result details read: "The liver demonstrates no mass but is enlarged. Gallbladder is now absent. There is no significant lymphadenopathy in the porta hepatis region. Common duct is not enlarged. The spleen is normal in density however is enlarged." This is summarized at the end of the report as "Moderate hepato-splenomegaly".
I had previously been experiencing ascites, which now appears to be resolved as is not noted in the scans. (This coincides with my abdomen looks a bit less pregnant now than it had been looking, though it still sticks out quite a bit, presumably from the hepatosplenomegaly). I had protein malnutrition and have been working hard to improve my levels (Creon and tons of protein). The CBC and comprehensive panel showed everything as normal except Albumin of 3.4 (Low - normal is 3.5-5.2 g/dL) and anion gap of 6 (Low - normal is 8-16 mmol/L). Granted most of my numbers are on the low side of normal - there is definitely an upward trend and this is the first time that many have shown up in the normal range this year.
Bottom line, if my protein situation is coming under control enough to relieve the ascites completely, but my liver and spleen are still angry and inflamed (over a year since my last surgery!), is it possible that SOD is the cause? Could it also be linked to the bile salt diarrhea? Or am I just so desperate to see a pattern that I am connecting the wrong dots?
Please let me know your thoughts! It's going to be a long five weeks wait to discuss these results with my doctors!
Thanks,
Hilary
P.S. On a side note, good news on the cancer front. My pancreas remnant is unremarkable other than missing its tail and associated tumor - nothing is noted there other than the resection. If there are metastases they would have to be small enough not to be picked up on CT or MRI. (Though I haven't gotten the Octreoscan results yet, which is what would make them light up...)
