Dilated pancreatic duct: Should I get a second opinion?

Posted by catt8722 @catt8722, Mar 6, 2020

I recently had a EUS. The result is a 3mm dilation in the distal end of the pancreatic duct. A fatty liver and a cyst on my right kidney. I was scheduled for a CT Scan but my insurance company has not approved the test. I am very scared. What is so confusing to me is that. I had the CT a year ago last month. Everything was normal. Was anyone diagnosed with this? I have been reading about this. It can be pancreatitis or cancer.

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UCSD-Moores Cancer Center is an NCI designated treatment center and has a pancreas program with noted surgeons and pancreatic oncologists. It is also a member of the Precision Promise consortium of the Pancreatic Cancer Action Network (PanCan.org) and would be my first choice.
https://health.ucsd.edu/specialties/cancer/programs/pancreatic/Pages/default.aspx
https://pancan.org/research/precision-promise/locations/

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@stageivsurvivor

UCSD-Moores Cancer Center is an NCI designated treatment center and has a pancreas program with noted surgeons and pancreatic oncologists. It is also a member of the Precision Promise consortium of the Pancreatic Cancer Action Network (PanCan.org) and would be my first choice.
https://health.ucsd.edu/specialties/cancer/programs/pancreatic/Pages/default.aspx
https://pancan.org/research/precision-promise/locations/

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@stageivsurvivor, thank you for the advice! I will look into UCSD program.

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@okienana

I had an MRI for my back and it showed up atrophy of pancreas and diffuse dilated duct of the pancreas. No visible mass. Then had a CT scan of pancreas and it showed a dilation of 6 mm. Still no visible mass. It also showed granulomas in lower right lung and granulomas scattered through spleen. Also showed fatty liver. My PCP is sending me to a gastroenterologist for further testing. PCP mentioned putting a camera down my throat and looking from the inside might be a good idea. Having virtual call tomorrow with gastro doc. Any specific questions I should ask? I have no symptoms. I have had Modified Duodenal Switch surgery 5 years ago. I don't know whether to be worried or not!!

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@okienana, how are you doing? If I may ask, what did you learn from your recent appointment with the gastroenterologist?

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@colleenyoung

@okienana, how are you doing? If I may ask, what did you learn from your recent appointment with the gastroenterologist?

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We made an appointment with the UCSD doctor in Oct. UCSD Dr already reviewed his file and didn’t call us in immediately. I hope this is good news. Thank you for checking with us.

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I had some recent abdominal pain and CT scan found varying dilation in entire pancreatic duct with 10mm measurement in head. They didn’t see an IPMN but recommended EUS for further evaluation.

Can a single IPMN cause dilation over entire duct?

Thank you

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@johnbc

I had some recent abdominal pain and CT scan found varying dilation in entire pancreatic duct with 10mm measurement in head. They didn’t see an IPMN but recommended EUS for further evaluation.

Can a single IPMN cause dilation over entire duct?

Thank you

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@johnbc, have you had the ultrasound in the meantime? Did they find the cause of the dialation?

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@colleenyoung

@johnbc, have you had the ultrasound in the meantime? Did they find the cause of the dialation?

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The EUS found the duct dilatation along with papilla projections and possible fishmouth ampulla indicative of IPMN but no IPMN clearly. No biopsy was taken.

Shouldn’t the CT scan or EUS clearly shown an IPMN if one is present?

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@johnbc

The EUS found the duct dilatation along with papilla projections and possible fishmouth ampulla indicative of IPMN but no IPMN clearly. No biopsy was taken.

Shouldn’t the CT scan or EUS clearly shown an IPMN if one is present?

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John, These tests can reveal enlargement (dilatation) of the pancreatic duct or one of the branches of the pancreatic duct. Sometimes a fine needle aspiration (FNA) biopsy may be necessary to confirm the diagnosis. Has your team suggested a biopsy?

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@colleenyoung

John, These tests can reveal enlargement (dilatation) of the pancreatic duct or one of the branches of the pancreatic duct. Sometimes a fine needle aspiration (FNA) biopsy may be necessary to confirm the diagnosis. Has your team suggested a biopsy?

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A biopsy during the EUS wasn’t taken to avoid pancreatitis. I have since had an MRI with and without contrast as well as MRCP. No ductal obstruction or focal lesion was found.

They are recommending another EUS with biopsy, since they can’t exclude possibly of IPMN.

I’ve had a CT scan, EUS w/o biopsy and now MRI/ MRCP. If I do have an IPMN, shouldn’t one of these imagings have shown it?

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@johnbc

A biopsy during the EUS wasn’t taken to avoid pancreatitis. I have since had an MRI with and without contrast as well as MRCP. No ductal obstruction or focal lesion was found.

They are recommending another EUS with biopsy, since they can’t exclude possibly of IPMN.

I’ve had a CT scan, EUS w/o biopsy and now MRI/ MRCP. If I do have an IPMN, shouldn’t one of these imagings have shown it?

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Also, the MRI/MRCP found dilation up to 8 mm when it was previously measured at 10 mm.

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