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
- Pseudotumor
During the period under study, patients with voluminous inflammatory pseudotumors of the pancreatic head, pseudo-aneurysms, hemorrhagic pseudocysts, or suspected cancer developing on chronic pancreatitis were treated by pancreatic resection and excluded [em-consulte.com]
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]
- 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]
- Epigastric Pain
Although there is occasionally no pain, severe epigastric pain may last many hours or several days. [chirhoclin.com]
- Choking
Most important – so much so that Karen still chokes up at the memory: “You feel like you have to be such a trooper, because they’re the sick one. You’re witnessing every bit of it, so you often feel helpless. Allow for that – for your own humanity. [pancreatica.org]
Liver, Gall & Pancreas
- Pancreatic Pain
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 is the principal complaint in patients with chronic calcifying pancreatitis [ 1 ]. [em-consulte.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]
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]
Endoscopic dilatation is one of the treatment options for stenosis of pancreaticogastrostomy (PG). However, the failure of endoscopic dilatation necessitates surgical approaches. [ncbi.nlm.nih.gov]
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]
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]
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]
Epidemiology United States data The incidence of biliary obstruction is approximately 5 cases per 1000 people. Race-related demographics The racial predilection depends on the cause of the biliary obstruction. [emedicine.medscape.com]
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
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]
Endoscopic sphincterotomy (EST) and nasobiliary drainage, which target the cause of AP, may prevent the transformation from AP to SAP and this may be adopted as an essential treatment strategy. [ncbi.nlm.nih.gov]
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]
Causes a blockage of the pancreatic duct and can prevent pancreatic enzymes from reaching the duodenum where they normally do their work. [quizlet.com]