Pancreatic cancer

2018 ◽  
pp. 387-398
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Pancreatic Cancer ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Abdominal Ultrasound ◽  
Serum Marker ◽  
Whipple Procedure ◽  
Fine Needle ◽  
Multidisciplinary Assessment ◽  
The Uk ◽  
Ct And Mri

Pancreatic cancer is the tenth most common cancer in the UK and is most often incurable at diagnosis. Presentation is generally with weight loss, jaundice, and or abdominal pain. Abdominal ultrasound, CT and MRI may be diagnostic. Tissue diagnosis is not usually necessary, but endoscopic ultrasound can obtain fine needle samples. The serum marker CA19-9 may be raised, but is not a screening test. Potentially curable lesions need careful multidisciplinary assessment for resectability, and a thorough assessment of patient fitness. The Whipple procedure is discussed as well as laparoscopic pancreatectomy. Adjuvant chemotherapy and palliative gemcitabine therapy are also covered.

scholarly journals Infected Pancreatic Necrosis Mimicking Pancreatic Cancer

2020 ◽  
Vol 14 (2) ◽  
pp. 436-442
Author(s):  
Jun Heo
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Pancreatic Necrosis ◽  
Necrotizing Pancreatitis ◽  
Needle Aspiration ◽  
Infected Pancreatic Necrosis ◽  
Ultrasound Guided ◽  
Fine Needle

Although infected pancreatic necrosis can develop as a result of rare conditions involving trauma, surgery, and systemic infection with an uncommon pathogen, it usually occurs as a complication of pancreatitis. Early phase of acute pancreatitis can be either edematous interstitial pancreatitis or necrotizing pancreatitis. The late complications of pancreatitis can be divided into pancreatic pseudocyst due to edematous interstitial pancreatitis or walled-off necrosis due to necrotizing pancreatitis. During any time course of pancreatitis, bacteremia can provoke infection inside or outside the pancreas. The patients with infected pancreatic necrosis may have fever, chills, and abdominal pain as inflammatory symptoms. These specific clinical presentations can differentiate infected pancreatic necrosis from other pancreatic diseases. Herein, I report an atypical case of infected pancreatic necrosis in which abdominal pain, elevation of white blood cell, and fever were not found at the time of admission. Rather, a 10-kg weight loss (from 81 to 71 kg) over 2 months nearly led to a misdiagnosis of pancreatic cancer. The patient was finally diagnosed based on endoscopic ultrasound-guided fine-needle aspiration. This case highlights that awareness of the natural course of pancreatitis and infected pancreatic necrosis is important. In addition, endoscopic ultrasound-guided fine-needle aspiration should be recommended for the diagnosis and treatment of indeterminate pancreatic lesions in selected patients.

Does Cholecystectomy Prior to the Diagnosis of Pancreatic Cancer Affect Outcome?

2008 ◽  
Vol 74 (7) ◽  
pp. 602-606 ◽  
Author(s):  
Stephen H. Gray ◽  
Mary T. Hawn ◽  
Meredith L. Kilgore ◽  
Huifeng Yun ◽  
John D. Christein
Keyword(s):  
Pancreatic Cancer ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Early Diagnosis ◽  
Cancer Diagnosis ◽  
Curative Resection ◽  
Tumor Stage ◽  
Seer Database ◽  
Patient Demographics ◽  
Medicare Data

Early diagnosis and curative resection are significant predictors of survival in patients with pancreatic cancer. We hypothesize that cholecystectomy within 12 months of pancreatic cancer affects 1-year survival. The Surveillance Epidemiology and End Result (SEER) database linked to Medicare data was used to identify patients diagnosed with pancreatic cancer who underwent cholecystectomy 1 to 12 months prior to cancer diagnosis. The SEER database identified 32,569 patients from 1995 to 2002; 415 (1.3%) underwent cholecystectomy prior to cancer diagnosis. Patients who underwent cholecystectomy had a higher proportion of diabetes (40.2% vs 20.5%; P < 0.01), obesity (8.9% vs 3.1%; P < 0.01), jaundice (17.3% vs 0.7%; P < 0.01), cholelithiasis (70.4% vs 4.2%; P < 0.01), choledocholithiasis (0.7% vs 0.0%; P < 0.01), weight loss (17.3% vs 4.7%; P < 0.01), abdominal pain (79.5% vs 22.5%), steatorrhea (0.7% vs 0.0%; P < 0.01), and cholecystitis (32.3% vs 1.7%; P < 0.0001). After controlling for tumor stage, patient demographics, and symptoms, survival at 1 year was significantly lower in patients undergoing cholecystectomy (OR, 0.75; 95% CI, 0.58–0.97). Recent cholecystectomy is associated with decreased 1-year survival among patients with pancreatic cancer. For patients older than 65 years of age, further evaluation prior to cholecystectomy may be necessary to exclude pancreatic cancer, especially patients with jaundice, weight loss, and steatorrhea.

scholarly journals CT-Guided Pancreatic Percutaneous Fine-Needle Biopsy in Differential Diagnosis between Pancreatic Cancer and Chronic Pancreatitis

HPB Surgery ◽  
1989 ◽  
Vol 1 (4) ◽  
pp. 309-317 ◽  
Author(s):  
Michele Carlucci ◽  
Alessandro Zerbi ◽  
Danilo Parolini ◽  
Sandro Sironi ◽  
Angelo Vanzulli ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Differential Diagnosis ◽  
Chronic Pancreatitis ◽  
Ct Scan ◽  
Needle Biopsy ◽  
Pancreatic Neoplasm ◽  
Abdominal Ultrasound ◽  
Fine Needle Biopsy ◽  
Ct Guided ◽  
Fine Needle

Differential diagnosis between pancreatic cancer and chronic pancreatitis is still difficult to establish. In 63 patients with suspected pancreatic neoplasm we performed: serum CA 19-9 assessment, abdominal ultrasound, CT scan and CT-guided pancreatic percutaneous fine-needle biopsy. The conclusive diagnosis was pancreatic cancer in 40 patients and chronic pancreatitis in 23 patients. With regard to the differential diagnosis, sensitivity and specificity were respectively 80% and 78% for serum CA 19-9, 75% and 65% for abdominal US, 85% and 70% for CT scan, 00% and 87% for percutaneous fine-needle biopsy. We conclude that CT-guided percutaneous fine-needle biopsy is the most reliable method for differential diagnosis between pancreatic cancer and chronic pancreatitis.

Retrograde jejunogastric intussusception presenting as haematemesis in a patient following pancreaticoduodenectomy

2020 ◽  
Vol 13 (3) ◽  
pp. e233851 ◽  
Author(s):  
Tyson A Moore ◽  
Yahya Al-Habbal ◽  
Julian M Choi
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
Abdominal Surgery ◽  
Remnant Stomach ◽  
Whipple Procedure ◽  
Differential Diagnoses ◽  
Rare Phenomenon ◽  
Jejunogastric Intussusception ◽  
Upper Abdominal

Intussusception is defined as the invagination of one part of the gastrointestinal tract into another. Jejunogastric intussusception is a rare phenomenon following major upper abdominal surgery, where its aetiology is not well understood. We describe a 68-year-old woman who presented with abdominal pain and haematemesis on the background of a previous pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer. Gastroscopy demonstrated retrograde jejunogastric intussusception, where part of the efferent jejunal limb had prolapsed into the remnant stomach. As a consequence, this intussuscepted segment had become oedematous and ischaemic. The patient subsequently underwent a laparotomy, where the original gastrojejunostomy was resected, which showed the intussuscepted jejunum. The non-viable portion was removed and a Roux-en-Y anastomosis was created. This case highlights the need to ‘think outside the box’ with respect to differential diagnoses when a patient presents with abdominal pain on the background of previous complex abdominal surgery.

Hemoperitoneum Secondary to Liver Lobe Torsion in a Cat

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Rebekah Knight ◽  
Janet Kovak McClaran
Keyword(s):  
Abdominal Pain ◽  
Surgical Management ◽  
Abdominal Ultrasound ◽  
Caudate Lobe ◽  
Successful Outcome ◽  
Liver Lobe ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Hepatic Mass ◽  
First Case

ABSTRACT A 5 yr old male British blue shorthair cat was presented collapsed with hypotension, hypothermia, and cranial abdominal pain. Abdominal ultrasound and abdominocentesis revealed hemoperitoneum and a suspected hepatic mass. Cytology of fine-needle aspirates of the mass was inconclusive, so exploratory celiotomy was performed for diagnostic and therapeutic purposes. An enlarged, hemorrhagic papillary process of the caudate lobe was identified, with twisting of the vasculature at the hilus, so a complete lobectomy was performed using a thoracoabdominal stapler. Histopathology was consistent with liver lobe torsion with no evidence of hepatocellular neoplasia identified. This report describes the first case of hemoperitoneum secondary to liver lobe torsion without evidence of hepatocellular neoplasia in a cat and demonstrates a successful outcome following surgical management with liver lobectomy.

scholarly journals A case of abdominal tuberculosis diagnosed by fine needle aspiration cytology (FNAC) of mesenteric lymph node

2017 ◽  
Vol 13 (3) ◽  
pp. 177-180
Author(s):  
Bijendra Kumar Rai ◽  
SU Kafle ◽  
A Sundas
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Fine Needle Aspiration ◽  
Abdominal Distension ◽  
Abdominal Tuberculosis ◽  
Needle Aspiration ◽  
Low Grade ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Background: The modes of presentation of abdominal tuberculosis can be vague resulting in diagnostic dilemma.Objective: To report a case of abdominal tuberculosis diagnosed by FNAC of a mesenteric lymphnode.Case: A 17-year-old boy presented in General out Patient department complaining of abdominal pain, abdominal distension, and low grade fever, anorexia and weight loss for 2 months. The examination revealed pallor, low body weight, doughing of abdomen and multiple palpable painless, slightly mobile abdominal lymph nodes. The ultrasonography (USG) guided fine needle aspiration cytology (FNAC) of a mesenteric lymphnode showed caseating necrosis suggestive of tuberculosis. The erythrocytes sedimentation rate (ESR) was raised.Conclusion: The abdominal tuberculosis can present with abdominal pain and abdominal distension associated with low grade fever, anorexia and weight loss. The diagnosis of abdominal tuberculosis can be confirmed by FNAC of the lymphnodes. Health Renaissance 2015;13(3): 177-180

Potential predictors of pancreatic cancer: A population-based screen.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 164-164 ◽  
Author(s):  
E. Ragulin-Coyne ◽  
J. K. Smith ◽  
S. Ng ◽  
T. P. McDade ◽  
S. A. Shah ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Weight Loss ◽  
Acute Pancreatitis ◽  
Logistic Regression ◽  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Bile Duct ◽  
Pancreatic Disease ◽  
Bile Duct Obstruction ◽  
Duct Obstruction

164 Background: Pancreatic cancer (PC) is the fourth leading cause of cancer-related death in the U.S. Unfortunately, PC is usually diagnosed at late stages. We hypothesized that certain diagnoses may precede PC diagnosis and assist in early identification of pancreatic cancer patients. Methods: SEER-Medicare 1991-2005 was used to identify PC patients. PC and prePC diagnoses were identified using ICD9 codes. We then examined pre-pancreatic cancer (prePC) diagnoses and compared the frequency of those diagnoses by PC stage at time of cancer diagnosis. Stepwise logistic regression was used to assess potential PrePC diagnoses. Risk factors were compared by stage at diagnosis using Kruskal-Wallis test, stratified univariate analysis and logistic regression. Time to diagnosis was calculated for each PrePC diagnosis. Results: 19,801 PC patients were identified. Significant (p<0.05) prePC diagnoses included acute pancreatitis, chronic pancreatitis, cyst/pseudocyst, other pancreatic disease, bile duct obstruction, diabetes, weight loss, jaundice, abdominal pain, hepatomegaly. Median time (months) and interquartile range percentiles (25th-75th) before PC diagnosis were as follows: acute pancreatitis 0.97 (0.33-8.6), chronic pancreatitis 1.56 (0.37-11), cyst/pseudocyst 0.83 (0.3-3.5), other pancreatic disease 0.47 (0.2-1.2), bile duct obstruction 0.4 (0.17- 0.83), diabetes 30.6 (11.3-59.8), weight loss 1.16 (0.43-5.1), jaundice 0.43 (0.2-0.8), abdominal pain 16 (1.07-55.5), hepatomegaly 1.06 (0.33-1.07). Patients diagnosed at AJCC stage 0 had a mean of 3.53 prePC diagnoses (±SD 1.42); stage IA, 2.80 (1.68); stage IB, 2.42 (1.57); stage IIA, 2.44 (1.63); stage IIB, 2.46 (1.64); stage III, 2.33 (1.59); and Stage IV, 1.79 (1.40) (p<0.001). Conclusions: PC patients who presented at later stages were less likely to have prePC claims identified prior to PC diagnosis compared with patients diagnosed at earlier stages. This analysis of potential prePC diagnoses suggests that access to care and earlier identification of PC related conditions may factor into the stage at which this lethal disease is identified. Further studies need to be conducted to identify and analyze additional predictors of PC and better screen individuals at risk. No significant financial relationships to disclose.

scholarly journals Cecal lymphoma in a male Rottweiler dog

2021 ◽  
Vol 7 (5) ◽  
pp. 01-04
Author(s):  
M.M. Shokry
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Abdominal Mass ◽  
Intestinal Anastomosis ◽  
Abdominal Ultrasound ◽  
Low Grade ◽  
Marked Weight

A 6-year-old male Rottweiler dog presented with a marked weight loss combined with abdominal pain and diarrhea over 3 month. Hematology revealed lymphocytosis, neutrophilia and eosinophilia. Abdominal ultrasound revealed a heteroechoic mid-abdominal mass with a focal hypoechoic area measuring 6.0 x 5.0 cm but with a confusing origin. The mass was resected and intestinal anastomosis was performed after celiotomy. Histopathology of the mass demonstrated massive lympho-proliferative lesions were diagnosed as low grade lymphoma with diffuse small lymphocytic (DSL-plasmacytoid) pattern. The dog was recovered and a one-month ultra sonography follow-up showed no-recurrence.

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