What We Treat
What We Treat
Bile duct stones/Gallstones
Presence of gallstones in the bile duct. Stones are formed in the gallbladder and sometimes they move out of the gallbladder and lodge in the bile duct. This can cause pain, jaundice (yellowing of the skin), fever, chills and/or infection.
Bile duct diseases
This can be several diseases such as cholangiocarcinoma (cancer of the bile duct), bile duct strictures, primary sclerosing cholangitis, primary biliary cirrhosis (PBC), choledochal cysts, Klatskin’s tumor, postcholecystectomy syndrome, biliary colic, cholestasis, Mirizzi’s syndrome, and bile duct leaks.
Often called biliary colic. This is the term often used for the severe episodes of pain that can be caused by gallstone blockage of the cystic duct. Inflamed gallbladder (cholecystitis) Inflammation of the gallbladder can be caused by gallstones, excessive alcohol use, infections, or even tumors that cause bile buildup.
Pain after gallbladder removal-Post cholecystectomy syndrome
Sometimes after gallbladder removal there are still symptoms similar to prior to removal. These include nausea, vomiting, upper abdominal pain, diarrhea, inability to eat, and bloating.
Sometimes with a bout of severe pancreatitis, a pancreatic cyst (pseudocyst) can form. Other types of cysts can also be found in the pancreas that require endoscopic ultrasound to confirm diagnosis. These include IPMN (intraductal pancreatic mucinous neoplasm), and benign pancreatic cysts.
Acute pancreatitis is a sudden attack causing inflammation of the pancreas and is often associated with severe abdominal pain.
Chronic pancreatitis is a chronic inflammation of the pancreas which results in destruction of the pancreatic tissue.
Sphincter of Oddi Dysfunction
The sphincter of Oddi is a muscular valve that surrounds the exit of the bile duct and pancreatic duct. Both of these ducts drain into the duodenum, which is the tube that comes off the end of the stomach. The sphincter is usually closed but opens to allow drainage of bile and pancreatic juices to flow to aid in digestion of food.
Sphincter of Oddi dysfunction (SOD) is not completely understood but it is thought the sphincter goes into spasm causing the back up of pancreatic and bile juices and in turn causes abdominal pain.
Unexplained upper abdominal pain
Repeated episodes of abdominal pain can arise from a variety of medical causes, including some serious conditions. Everyone who has unexplained abdominal pain requires a medical evaluation by a doctor.
Non-cardiac chest pain
Non-cardiac chest pain is a term used to describe chest pain that resembles heart pain (also called angina) in patients who do not have heart disease. The pain typically is felt behind the breast bone (sternum) and is described as oppressive, squeezing or pressure-like. This can be caused by a variety of factors including gastroesophageal reflux, esophageal motility disorders, and/or biliary and pancreatic disorders.
Abdominal pain and diarrhea that occurs at the same time can be caused by a variety of factors. These can include indigestion, a viral infection such as the stomach flu, or an intestinal disease. It’s important to pinpoint the cause of your symptoms.
Tumors of the bile duct
Cancer of the bile ducts (cholangiocarcinoma) is rare. It can originate anywhere in the bile ducts, particularly in those outside of the liver. Being older or having primary sclerosing cholangitis increases the risk of developing this cancer.
Tumors of the pancreas
There are two very important things to know about neoplasms of the pancreas. First, some, such as the “intraductal papillary mucinous neoplasm,” are curable precancerous lesions. Just as colon cancer arises from curable precancerous colon polyps, so to do some pancreatic cancers arise from curable precancerous lesions.
A variety of different types of neoplasms (tumors) can arise in the pancreas, such as ductal adenocarcinoma and pancreatic neuroendocrine tumor, and these different tumor types are important to recognize because they are often treated differently, and because they are associated with different prognoses (predicted outcomes).
Trained expert pathologists usually establish the diagnosis of a specific type of neoplasm. They do this either from biopsies of the tumor or by examining resected (removed) tumors.
Tumors of the ampulla
Ampullary carcinoma is a rare malignant tumor originating at the ampulla of Vater, in the last centimeter of the common bile duct, where it passes through the wall of the duodenum and ampullary papilla. Patients typically present with symptoms related to biliary obstruction. Sometimes during an upper endoscopy, adenoma polyps are found and biopsied. These polyps are usually removed as they are considered precancerous and if left untreated, cancer may develop or they may cause blockage of the bile/pancreatic ducts.
Tumors of the duodenum
Benign small-bowel tumors may develop as a single lesion or as multiple lesions of several subtypes. Subtypes include hyperplastic polyps, adenomas, gut stromal tumors, lipomas, and hemangiomas.
Primary sclerosing cholangitis is a disease of the bile ducts. Bile ducts carry the digestive liquid bile from the liver to the small intestine. In primary sclerosing cholangitis, inflammation causes scars within the bile ducts. These scars make the ducts hard and narrow and gradually cause serious liver damage.