There are a number of pathologies of the GI tract that have overlapping symptoms. There can also be one or more co-morbidities complicating a diagnosis. Community hospitals and small primary medical centers do not have the level of expertise found at comprehensive medical centers in major metropolitan areas.

When I had onset of symptoms, It was something I never experienced before. I first went to a PCP…I had two and chose the one in NYC rather than close to home figuring he had a larger and more diverse patient base. Over the course of three days, visits resulting in a sonogram, blood and hematology tests and a physical exam. Not being able to make a conclusive Dx, my PCP escalated the testing and called his medical school colleague a few blocks away at an NCI designated center of excellence with a Hepatobiliary department and high volume pancreas center. A CT with contrast was immediately ordered which imaged a neoplasm. An EUS quickly followed to do a tissue biopsy and an ERCP the following morning. My PCP knew his limitations and didn’t hesitate calling in a Hepatobiliary surgical oncologist who rapidly made the Dx.

When I have something out of the ordinary, I travel to a major center-in my case NYC or Philadelphia where major centers have a higher level of expertise.

I should have sent my comment to you rather than HOPETHEREIS NOTHING.
I didn't pay enough attention to the timing of the postings--and I can't fix it now as I am technologically challenged! Same symptoms, same long time for diagnosis--finally caught on camera by a dedicated gastroenterologist. Hope you can read my posting to HOPETHEREIS NOTHING.

I'm checking in @kag734. How are you doing?