Presentation
We present the case of a 65-year-old man with a pancreatic nonfunctioning neuroendocrine tumor causing main pancreatic duct obstruction that presented as excessive hyperglycemia. [ncbi.nlm.nih.gov]
Similar to our case, 17 of 20 patients presenting with AOSPD had a history significant for chronic pancreatitis. Of the 20 patients, 10 had a prior pancreatic procedure within 1 month of presentation. [acgcasereports.gi.org]
Tumors of the body and tail are often larger at the time of presentation. Carcinoma of the ampulla has the best prognosis, because these lesions are detected at a smaller size/cause symptoms of presentation earlier. [med-ed.virginia.edu]
Entire Body System
- Fever
Fever Some people with bile duct cancer develop fevers. Nausea and vomiting These are not common symptoms of bile duct cancer, but they may occur in people who develop an infection (cholangitis) as a result of bile duct blockage. [cancer.org]
Fever Common during advanced disease Obstruction of bile ducts can lead to infection in the bile ducts and possibly the liver. The body's immune response to the infection results in a fever. [pathology.jhu.edu]
Other symptoms can include: Swollen and tender abdomen Nausea and vomiting Fever Rapid pulse [pancreasfoundation.org]
Other symptoms may include a swollen and tender abdomen nausea and vomiting fever a rapid pulse Severe acute pancreatitis may cause dehydration and low blood pressure. The heart, lungs, or kidneys can fail. [surgery.ucsf.edu]
Symptoms Symptoms may include: Abdominal pain in the upper right side Dark urine Fever Itching Jaundice (yellow skin color) Nausea and vomiting Pale-colored stools Exams and Tests Your health care provider will examine you and feel your belly. [stlukes-stl.com]
- Chills
Warning About ERCP If you have any of the following symptoms within 72 hours after ERCP, call your doctor and seek emergency care: Severe abdominal pain A continuous cough Fever Chills Chest pain Nausea or vomiting Bleeding or vomiting blood Blood in [webmd.com]
Chills Common Infection caused by obstruction of the bile ducts and/or biological therapy (vaccines). Antibiotics May require a stent to relieve obstruction. The stent can be placed endoscopically or percutaneously through the liver. [pathology.jhu.edu]
“Thanksgiving week, the night before the scheduled ERCP, I woke up with fever, chills, and vomiting. The next day, upon hearing of this, my gastroenterologist postponed the procedure. On Thanksgiving Day I could barely eat at all. [pancreatica.org]
Symptoms of transfusion reaction: chills fever feeling of heat in the face breathing difficulty itching nervousness fall in blood pressure shock Suspect/manifest blood transfusion reaction: Stop transfusion immediately Start treatment if necessary (intravenous [oncolex.org]
- Falling
Albrecht, E. (1901) Ein Fall von Pankreasbildung in einem Meckelschen Divertikel. Münchener Med. Wochenschrift 48:20612062. Albrecht, E. und L. [anatomyatlases.org]
There is no way to prevent hair from falling out as a result of chemotherapy. Hair usually begins growing back within one month after the treatment ends. Uncommon Radiation therapy can cause hair loss in affected area. [pathology.jhu.edu]
This results in the blood sugar falling below normal levels, resulting in faintness and eventually coma. [ddc.musc.edu]
Rest during the day by relaxing in a good chair, but try not to fall asleep. Speak to your doctor about lasting sleep disturbances. Nutrition Having a reduced appetite or intake of food can also result in a lack of strength and energy. [oncolex.org]
- Rigor
The other imperative is to pursue the research studies necessary to improve current methods and to evaluate all of them rigorously. [gastrohep.com]
- Lymphadenopathy
The findings are: Discontinuous dilatation Bile wall thickening at the level of the porta hepatis Lymphadenopathy Primary sclerosing cholangitis. late CT findings Primary sclerosing cholangitis (4) Late CT features are seen on the images on the left. [radiologyassistant.nl]
Respiratoric
- Sore Throat
It is common to have a sore throat and light abdominal pain (including gas pain) after the procedure. Pancreatitis is the most threatening complication and occurs in 4–15% of cases. [oncolex.org]
- Respiratory Insufficiency
Any evidence of respiratory insufficiency requires a chest X-Ray to assess for pulmonary edema or acute respiratory distress syndrome (ARDS). 32,33 If vomiting occurs, an abdominal X-Ray should be performed to assess for ileus and a nasogastric tube inserted [tmj.ro]
Gastrointestinal
- Abdominal Pain
The clinical presentation of CP is dominated by abdominal pain associated with loss of weight and denutrition. The mechanisms of pain generation in CP are multiple and complex. [ncbi.nlm.nih.gov]
Upper Abdominal Pain In Pancreatic Cancer : Abdominal pain is a common symptom. It often radiates to the middle or upper back and worsens after eating or when lying down. Upper abdominal pain commonly occurs with advanced pancreatic cancer. [columbiasurgery.org]
Symptoms of chronic pancreatitis include abdominal pain, nausea, vomiting, weight loss, diarrhea, and diabetes. Abdominal pain is the most common presenting symptom. The abdominal pain is typically epigastric and radiates to the back. [pancreapedia.org]
It may also be used to rule out other conditions that can cause abdominal pain. [nyulangone.org]
Case Report A 66 year old female patient presented to the emergency department with severe abdominal pain and vomiting. [saudisurgj.org]
- Overeating
However, the frequency of SAP remains stable over time. Biliary calculi and alcohol abuse are the most common causes of AP. Other causes such as iatrogenic factors, sphincter of Oddi dysfunction (SOD) and eating disorders also cannot be omitted. [ncbi.nlm.nih.gov]
And one day, I was pulling some garden hose over our wood deck, and I noticed the sound was eerily like the radiation machine as it would move into position.” [pancreatica.org]
Save over 20% compared to the individual article price. [karger.com]
As the pancreas begins to scar and more than 90% of the tissue is destroyed over time (often over many years) patients develop fatty stools and fat malabsorption because they do not produce enough digestive enzymes; and diabetes due to loss of insulin [pancreapedia.org]
Severe pancreatitis, especially if it is not diagnosed and treated quickly, can lead to inflammation all over the body, called systemic inflammatory response syndrome. [nyulangone.org]
- Severe Abdominal Pain
Pancreatitis Pancreatic duct blockages can lead to pancreatitis, an inflammatory process that can cause severe abdominal pain, vomiting, and diarrhea. [hopkinscf.org]
Warning About ERCP If you have any of the following symptoms within 72 hours after ERCP, call your doctor and seek emergency care: Severe abdominal pain A continuous cough Fever Chills Chest pain Nausea or vomiting Bleeding or vomiting blood Blood in [webmd.com]
Most patients suffer severe abdominal pain, which radiates straight through to the back in about 50%; rarely, pain is first felt in the lower abdomen. [chirhoclin.com]
Case Report A 66 year old female patient presented to the emergency department with severe abdominal pain and vomiting. [saudisurgj.org]
- Blood in Stool
They may take a blood or stool sample for examination under a microscope. [nyulangone.org]
There are two types of methods for doing this; 1) indirect methods involving collections of blood or stool, and 2) a direct methods which are more invasive. These tests are often used to determine exocrine pancreatic insufficiency. [pancreapedia.org]
- Clay-Colored Stool
Dark urine and light or clay-colored stools can also be associated with jaundice. Jaundice occurs when bilirubin, a component of bile, builds up in your blood. [columbiasurgery.org]
Cardiovascular
- Heart Failure
Heart failure should be treated by appropriate correction of volume status. Renal failure should be treated by increased fluid replacement if there is prerenal azotemia. Dialysis (usually peritoneal) may also be required. [chirhoclin.com]
/encephalopathy/coma; - Cardiovascular: New York Heart Association Class IV heart failure; - Respiratory: chronic restrictive, obstructive, or vascular disease resulting in severe exercise restriction (i.e., unable to climb stairs or perform household [tmj.ro]
Precautions must be taken for kidney failure, heart failure, lung failure, large fluid and electrolyte loss, diabetes mellitus and liver failure. [oncolex.org]
- Hypotension
BP may be transiently high or low, with significant postural hypotension. Temperature may be normal or even subnormal at first but may increase to 37.7 to 38.3° C (100 to 101° F) within a few hours. Sensorium may be blunted to the point of semicoma. [chirhoclin.com]
Temporary side effects in the form of orthostatic hypotension and diarrhea are relatively common the first 24-48 hours. Back pain, usually in the form of soreness for 2-4 days is experienced by some. [oncolex.org]
Liver, Gall & Pancreas
- Pancreatic Pain
Pain is the principal complaint in patients with chronic calcifying pancreatitis [ 1 ]. [em-consulte.com]
Pancreatic infantilism Pancreatic insufficiency Pancreatic mass Pancreatic necrosis Pancreatic pain Pancreatic trypsinogen deficiency Pancreatitis (inflammation of pancreas) from gallstone Pancreatitis, gallstone Pseudolipomatosis hypertrophy of pancreas [icd9data.com]
Pain usually develops suddenly in gallstone pancreatitis versus over a few weeks in alcoholic pancreatitis. Pain is severe, often requiring large doses of parenteral narcotics. [chirhoclin.com]
The use of pancreatic enzymes was not considered to indicate pancreatic insufficiency, because they had also been prescribed as part of pain management. [nejm.org]
Skin
- Flushing
Clinically this is noteworthy by the passage of large bowel movements, which a strong odor and are difficult to flush down the toilet because of their high content of fat. [ddc.musc.edu]
Trypsin is flushed into the duodenal to allow for food digestion by bicarbonate rich fluid. A loss of function in CFTR prevents adequate formation of bicarbonate fluid, therefore increasing the amount of trypsin around the pancreas. [pancreapedia.org]
The abdomen is flushed and a drain is placed in the anastomosis area. The abdominal wall is closed by two layers of running sutures. The skin is closed with staples. The surgical specimen is marked by the surgeon and sent to the pathologist. [oncolex.org]
Treatment
New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer. National Cancer Institute of the United States. National Cancer Institute of Canada. [books.google.de]
Treatment was considered to have failed in patients whose treatment was converted from endoscopic drainage to surgery and in those who died because of treatment. [nejm.org]
Precautions in connection with sunbathing should be followed under medical cancer treatment and for 2-3 weeks after end of treatment. Drug cancer treatment includes chemotherapy, antibodies and other drugs used in cancer treatment. [oncolex.org]
We included trials comparing endoscopic versus surgical interventions as well as trials comparing either endoscopic or surgical interventions to conservative treatment (i.e. non-invasive treatment modalities). [cochrane.org]
None of the patients had undergone previous endoscopic procedures for the treatment of biliary or pancreatic disorders. [em-consulte.com]
Prognosis
BACKGROUND: The prognosis of pancreatic ductal adenocarcinoma remains very poor, but is better in patients with a small tumor without local infiltration. [ncbi.nlm.nih.gov]
To keep learning about pancreatic cancer: Overview | Causes | Symptoms | Genetics | Diagnosis | Treatment | Prognosis | Coping [columbiasurgery.org]
Outlook (Prognosis) If the blockage is not corrected, it can lead to life-threatening infection and a dangerous buildup of bilirubin. If the blockage lasts a long time, chronic liver disease can result. [stlukes-stl.com]
Carcinoma of the ampulla has the best prognosis, because these lesions are detected at a smaller size/cause symptoms of presentation earlier. [med-ed.virginia.edu]
Etiology
The most frequent etiologies of AP are gallstone(s) and alcohol abuse. The early management of AP includes in all cases, fluid resuscitation, pain control and transient fasting. [ncbi.nlm.nih.gov]
Article 143 Downloads 1 Citations Opinion statement The treatment of pancreatic duct strictures is based on an accurate assessment of the etiology of the disease, and then the degree of symptomatology. [link.springer.com]
Advances in the Etiology of Chronic Pancreatitis. Dig Dis 28 p324-329, 2010. Available online at http://www.ncbi.nlm.nih.gov/pubmed/20814206 through http://www.ncbi.nlm.nih.gov. Accessed April 2011. [labtestsonline.org]
Her medical history was significant for type 2 diabetes and chronic pancreatitis of unclear etiology, possibly hereditary given a history of pancreatic cancer on her maternal side. [acgcasereports.gi.org]
Epidemiology
National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: pancreatic cancer. Available online at https://seer.cancer.gov/statfacts/html/pancreas.html. Accessed March 31, 2019. [labtestsonline.org]
Epidemiology of alcohol-related liver and pancreatic disease in the United States. Arch Intern Med 168:649–656, 2008. PMID: 18362258 [pancreapedia.org]
Epidemiology and outcome of acute pancreatitis. Br J Surg 1987; 74: 398-401. Tandon M, Tropaziam M, Pezilli R et al. Endoscopic ultrasound in idhiopatic acute pancreatitis. Am J Gastroenterol 2001; 96:705-709. Wilcox CM, Varadarajulu S, Eloubeidi M. [sapd.es]
The epidemiology and impact of pancreatic diseases in the United States. Curr Gastroenterol Rep 2005;7:90-5. [ PUBMED ] 9. Ochiai K, Kaneko K, Kitagawa M, Ando H, Hayakawa T. [saudisurgj.org]
Epidemiology, aetiology and outcome of acute and chronic pancreatitis: An update. Best Pract Res Clin Gastroenterol. 2008;22(1):45-63. 6. Anderson R, Eckerwall G, Haraldsen P. Novel strategies for the management of severe acute pancreatitis. [tmj.ro]
Pathophysiology
Pancreatic physiology, pathophysiology, acute and chronic pancreatitis. Gastrointestinal Teaching Project, American Gastroenterological Association. 2003. [pancreapedia.org]
Most studies of the pathophysiology of chronic pancreatitis are performed with patients who drink alcohol. [aafp.org]
[…] in the hepatodudoenal ligament and then courses through the head of the pancreas for approximately 2 cm; it joins the terminal part of the pancreatic duct to form the ampulla of Vater before passing through the papilla of Vater into the duodenum. [1] Pathophysiology [emedicine.medscape.com]
PATHOPHYSIOLOGY The precise mechanism by which obstruction of the sphincter of Oddi by a gallstone or microlithiasis (sludge) causes pancreatitis is unclear, although it probably involves increased ductal pressure. [tmj.ro]
Prevention
This study was to review the outcomes of pancreatic duct obstruction and explore the prevention of pancreatic duct obstruction. [ncbi.nlm.nih.gov]
Preventing a recurrence is a major goal of treatment, with efforts focused on identifying the underlying cause and triggers to prevent future episodes. [pancreasfoundation.org]
Prevention Be aware of any risk factors you have, so that you can get prompt diagnosis and treatment if a bile duct becomes blocked. The blockage itself may not be preventable. References Anstee QM, Jones DEJ. Liver and biliary tract disease. [stlukes-stl.com]
Prevention Be aware of any risk factors you have, so that you can get prompt diagnosis and treatment if a bile duct becomes blocked. The blockage itself may not be preventable. References Fogel EL, Sherman S. [mountsinai.org]