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Conflicting test results for pancreatitis symptoms
In March of this year I went to the emergency room with stomach pain. They suspected Pancreatitis. I was given a CT scan with the following results
Moderate peripancreatic fat stranding and edematous appearance of the distal pancreatic body and tail compatible with findings of acute pancreatitis. No drainable fluid collections.
I was also given a MR MRCP with the following results
PANCREAS: Edematous appearance at the pancreatic body and tail along with surrounding edema. No cystic or solid lesion. No pancreatic ductal dilatation. I was hospitalized for 3 days.
In May I returned with stomach pain and was given another CT with contrast with the following results
PANCREAS: Peripancreatic mesenteric stranding/ edema without focal fluid collection. Again hospitalized for 3 days.
I was referred for an Upper EUS in June with the following results
ENDOSONOGRAPHIC FINDING:- The stomach and duodenum were examined endosonographically.- Visualized portions of the liver, spleen, left adrenal gland, left kidney, gallbladder, common bile duct, pancreas and main pancreatic duct were normal on ultrasound examination.
In was then sent for an MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP) WITH AND WITHOUT CONTRAST.
the results were PANCREAS AND DUCT: Within mild evidence of motion artifact, no suspicious signal
or enhancement abnormality throughout pancreatic parenchyma. No pancreatic duct
dilation. No peripancreatic fluid detected.
I returned to the hospital in November mainly due to a panic attack with stomach pain and was given another CT with contrast. the results were different this time.
. Uncomplicated acute pancreatitis with a 1.2 cm hypoattenuating lesion in the uncinate process, possibly representing cystadenoma or IPMN. I was not hospitalized and was just put on a bed in the hallway then released
I'm confused that 2 CT scans, an MR MRCP an EUS and a MRCP all were fine then the CT in November indicated a 1.2 cm hypoattenuating lesion in the uncinate process of my pancreas, possibly representing cystadenoma or IPMN.
In was told I was fine after the last CT but I'm confused as to why the numerous prior tests were fine but the last CT showed a lesion with possible IPMN. Sadly I googled it and am now concerned. Any insight will be appreciated. Oh, I saw my PCP last week and he didn't mention it and I did not review my results in depth until today. I'll contact him Monday. Thanks for reading this long account. I'm a 69 year old male if that matters.
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Sorry to hear of all your troubles. That is frustrating. Clearly something is going on, but I just read a lesion that size has a good chance of being benign and that cancer in the uncinate process is rare if that’s of any comfort. Your CT was 6 months after the EUS, but maybe it will turn out to be some sort of irritation from the pancreatitis and not a cyst. I will tell you two years ago my CT showed an incidental finding of a 7 mm cyst on the head of my pancreas. My heart sank. You never want to hear anything about your pancreas. Then I had an MRI MRCP and there was no cyst found with the explanation the CT was averaging density with a fatty deposit outside the pancreas. False alarm. Phew! One year later a CT still showed a normal pancreas. Great! Now, a year after the CT I just had an MRI MRCP (in a high risk monitoring program due to BRCA2 mutation) and it showed the main pancreatic duct is 2.5 cm dilated (should be < 3 mm). Not good! There is also a blurred spot that is possibly a cluster of cysts. So now I’m scheduled for an EUS on 2/6. Scary? Yep! I’m female 67. I’m already in treatment for breast cancer and neuroendocrine lung cancer so I don’t need to add to my cancer collection. Hopefully you will now have an MRCP or EUS to verify the CT findings and I hope it turns out to be nothing. We can go thru our little scare together. Praying for a good outcome for both of us.
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6 Reactions@californiazebra
Thank you for your response. It has eased my anxiety some. I'm sorry for your troubles but you seem to be attending to your issues. Hoping for great outcomes for you.
I guess my concern is that all the tests done were more advanced than the last CT and going from nothing to a 1.2 cm growth in 5 months has me confused. 5 normal test then one abnormal in 5 months? When the Gastrointestinal Dr. found nothing on the UES he referred me for a MRCP and said he wanted to have the best test verify his findings. Negative findings so I pretty much forgot about it. Crazy. I guess I best get ready for more testing. Good luck on your upcoming testing.
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2 ReactionsHello @ernessch and welcome to Mayo Clinic Connecy. I see that @californiazebra has responded to you and shared her own experience. I see that you have had many visits to the ER and that you currently see a gastroenterologist. I'm wondering if it would be possible to request a consultation with a doctor specializing in the pancreas.
This type of consultation might put your mind at ease. Have you considered this option?
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4 Reactions@hopeful33250
Didn't know there was one. I assumed being sent to a gastroenterologist was the appropriate referral. I sent my primary care Dr. a message requesting guidance as to what I need to do next. No symptoms so that's a good thing. I rechecked the dates I received tests and the MRCP was in September so going from no issues found to the CT in November, 3 months later has me confused.
Thanks for your advice. I'll start my own search since my insurance allows me to self-refer.
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1 Reaction@ernessch
I was told EUS is the best test but I did the MRCP first because I don’t like doing invasive tests just for monitoring. The gastroenterologist I’m seeing for this specializes in the pancreas. Look for a major health center like Mayo, teaching hospitals or cancer centers that have pancreatic cancer programs. You want someone who does a lot of EUS procedures not only for safety but to be skilled at EUS biopsies in case they find something to biopsy. Experience matters. Even if this is benign or not really even a cyst, you need a team that will figure out why you keep having pancreatitis. It sounds like you’ve had a rough year with that. Please keep us posted.
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5 ReactionsThanks for your reply. My gastroenterologist does specialize in pancreatic cancer and GI Oncology. I just looked up his qualifications. He is on staff at my Hospital and they are affiliated with M.D Anderson which is a top cancer hospital down south where I live. When he did my UES he told me he would take a needle aspiration If he saw anything of concern. I will however seek all the information I can before making a decision as to treatment. This forum has given me information I wouldn't have thought to consider.
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3 Reactions@ernessch
Great! MD Anderson is top notch.
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4 Reactions