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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@catt8722 I can imagine that you're worried after the results of the endoscopic ultrasound (EUS) showed dilation in the distal end of the pancreatic duct, a fatty liver and a cyst on your kidney, especially since a CT scan a year ago showed nothing abnormal. Perhaps this is good news and they caught things early. I'm tagging @christina315 and @2011panc on this discussion too as they may have similar experiences to share.

Catt, what symptoms did you have that led to your getting the EUS?

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@colleenyoung

@catt8722 I can imagine that you're worried after the results of the endoscopic ultrasound (EUS) showed dilation in the distal end of the pancreatic duct, a fatty liver and a cyst on your kidney, especially since a CT scan a year ago showed nothing abnormal. Perhaps this is good news and they caught things early. I'm tagging @christina315 and @2011panc on this discussion too as they may have similar experiences to share.

Catt, what symptoms did you have that led to your getting the EUS?

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@catt8722 Unfortunately for you, I have had none of the issues you have mentioned. I do have a cyst in my lower left quadrant that we are watching, but it is closest to my ovary. From watching family members with fatty liver, I am grateful not to have to deal with that. I hope you find answers and reassurance soon. Blessings to you.

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Brief History: I've been struggling with upper abdominal pain for about 9 months with 25lb weight loss due to nausea/pain after eating, poor appetite (feeling full), bloating, excessive weird belching. Gallbladder removed in hope of it being the problem. (Nope)! I've had numerous tests that don't reveal any masses but some abnormal findings. Ct scan showed dilated main pancreatic duct at 6mm and CBD dilated at 9mm. I had further testing -MRCP which showed main pancreatic duct was no longer dialed but still prominent at <4mm and CBD down to 6mm. My gastro Dr. does not seem to think any further follow-up is needed since the dilation has decreased. But still no relief with my issues after complete diet change. I I am confused after researching and learning of the "double duct sign" that there seems to be NO concern?

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@kate1951

Brief History: I've been struggling with upper abdominal pain for about 9 months with 25lb weight loss due to nausea/pain after eating, poor appetite (feeling full), bloating, excessive weird belching. Gallbladder removed in hope of it being the problem. (Nope)! I've had numerous tests that don't reveal any masses but some abnormal findings. Ct scan showed dilated main pancreatic duct at 6mm and CBD dilated at 9mm. I had further testing -MRCP which showed main pancreatic duct was no longer dialed but still prominent at <4mm and CBD down to 6mm. My gastro Dr. does not seem to think any further follow-up is needed since the dilation has decreased. But still no relief with my issues after complete diet change. I I am confused after researching and learning of the "double duct sign" that there seems to be NO concern?

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Hello @kate1951 and welcome to Mayo Clinic Connect. I can certainly understand your concern. Any problems with the pancreas usually will cause concern. Personally, I've had three surgeries for a rare form of cancer in the upper digestive tract and when pancreatic cysts showed up on a CT, I became anxious as well. After almost 10 years of follow up the cysts have remained unchanged so I feel less anxious now.

I'm wondering if your GI doctor ran blood tests to check on the functioning of the pancreas? If you have access to the patient portal all blood tests and scan reports should show up there.

Have you had an exam with a GI doctor who specializes in the pancreas? If not, this might be a good option to determine if there is a problem.

There are a lot of post-gallbladder surgery complications as well. You might want to read about the symptoms that others have experienced after gallbladder removal. Here are some links to those discussions, https://connect.mayoclinic.org/discussion/pain-at-old-gall-bladder-surgical-site/ and https://connect.mayoclinic.org/discussion/post-cholesectomy-gallbladder-removal-chronic-back-pain/.

I would encourage you to be proactive in seeking another opinion rather than worrying about what you have been told. The best place for a second opinion would be a university medical school or a facility like Mayo Clinic. These health facilities tend to be research-oriented and tend to be very good at diagnosing complicated situations.

Is there a facility like that near you?

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@hopeful33250

Hello @kate1951 and welcome to Mayo Clinic Connect. I can certainly understand your concern. Any problems with the pancreas usually will cause concern. Personally, I've had three surgeries for a rare form of cancer in the upper digestive tract and when pancreatic cysts showed up on a CT, I became anxious as well. After almost 10 years of follow up the cysts have remained unchanged so I feel less anxious now.

I'm wondering if your GI doctor ran blood tests to check on the functioning of the pancreas? If you have access to the patient portal all blood tests and scan reports should show up there.

Have you had an exam with a GI doctor who specializes in the pancreas? If not, this might be a good option to determine if there is a problem.

There are a lot of post-gallbladder surgery complications as well. You might want to read about the symptoms that others have experienced after gallbladder removal. Here are some links to those discussions, https://connect.mayoclinic.org/discussion/pain-at-old-gall-bladder-surgical-site/ and https://connect.mayoclinic.org/discussion/post-cholesectomy-gallbladder-removal-chronic-back-pain/.

I would encourage you to be proactive in seeking another opinion rather than worrying about what you have been told. The best place for a second opinion would be a university medical school or a facility like Mayo Clinic. These health facilities tend to be research-oriented and tend to be very good at diagnosing complicated situations.

Is there a facility like that near you?

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Hi Teresa, Thank you for your response and suggestions. My lipase and amylase bloodwork is within normal range. My liver enzymes flunctuate but are within normal range at this time. My GGT is 204- without any known reason to be (I am not a drinker). There seems to be no rhyme or reason behind what I eat. Everything I eat causes pain. I am considering Mayo-Clinic soon if no change. I have given up on my local healthcare system in finding the cause. Its frustrating that they give up so easily and leave us hanging to "watch & see".

Thank you, again
Blessings

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@kate1951

Hi Teresa, Thank you for your response and suggestions. My lipase and amylase bloodwork is within normal range. My liver enzymes flunctuate but are within normal range at this time. My GGT is 204- without any known reason to be (I am not a drinker). There seems to be no rhyme or reason behind what I eat. Everything I eat causes pain. I am considering Mayo-Clinic soon if no change. I have given up on my local healthcare system in finding the cause. Its frustrating that they give up so easily and leave us hanging to "watch & see".

Thank you, again
Blessings

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Hello @kate1951

I am glad that the blood work was within a normal range. The "watch and see" that doctors often tell us can be especially frustrating when there are such difficult symptoms as you have experienced.

I'm glad that you are considering a second opinion. It could be that a review of your records by a specialty hospital will provide some answers.

I would encourage you to look at the National Pancreas Foundation website, https://pancreasfoundation.org/. Here you can get information about Pancreas Centers of Excellence, as well as good patient information. The more you can learn the more confident you will feel about your current situation.

I look forward to hearing from you again. Will you continue to post updates as you learn more?

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@hopeful33250

Hello @kate1951

I am glad that the blood work was within a normal range. The "watch and see" that doctors often tell us can be especially frustrating when there are such difficult symptoms as you have experienced.

I'm glad that you are considering a second opinion. It could be that a review of your records by a specialty hospital will provide some answers.

I would encourage you to look at the National Pancreas Foundation website, https://pancreasfoundation.org/. Here you can get information about Pancreas Centers of Excellence, as well as good patient information. The more you can learn the more confident you will feel about your current situation.

I look forward to hearing from you again. Will you continue to post updates as you learn more?

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Thank you so much. I will definitely look into the information you have suggested and also update…soon! Thanks again!

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I recently went into the ER with abdominal pain accompanied with lower back pain. I had a CT done that showed scattered legions in my liver largest measuring 5 cm. Also discovered was the dilation of my pancreatic duct at 5 mm. My doctor seemed concerned about the cysts on my liver but didn't even mention my pancreas. After looking into the matter I feel that the dilated pancreatic duct could be far more significant than the scattered cysts on my liver.
Should I ask for a referral to a specialist?

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@dtalent

I recently went into the ER with abdominal pain accompanied with lower back pain. I had a CT done that showed scattered legions in my liver largest measuring 5 cm. Also discovered was the dilation of my pancreatic duct at 5 mm. My doctor seemed concerned about the cysts on my liver but didn't even mention my pancreas. After looking into the matter I feel that the dilated pancreatic duct could be far more significant than the scattered cysts on my liver.
Should I ask for a referral to a specialist?

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Hi @dtalent, welcome. You may have noticed that I moved your question to this existing discussion where @kate1951 asked a very similar question: Dilated pancreatic duct: Should I get a second opinion?

I moved your message here so that you can connect with Kate and @hopeful33250. While I'm not qualified to know whether the liver cysts or the dilated pancreatic duct is more concerning, I do agree with asking your doctor questions to understand why they are concerned and what the next steps are. I would also talk to them about a referral to a specialist. Do you have a large medical center near you?

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Thank you, I live in Spokane, WA we do have Sacred Heart Hospital.

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@dtalent

I recently went into the ER with abdominal pain accompanied with lower back pain. I had a CT done that showed scattered legions in my liver largest measuring 5 cm. Also discovered was the dilation of my pancreatic duct at 5 mm. My doctor seemed concerned about the cysts on my liver but didn't even mention my pancreas. After looking into the matter I feel that the dilated pancreatic duct could be far more significant than the scattered cysts on my liver.
Should I ask for a referral to a specialist?

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Hello @dtalent

I would like to join Colleen in welcoming you to Mayo Clinic Connect. I am glad that you posted your question regarding the liver lesions and the pancreatic duct problem. I have personally had pancreatic cysts as well as lesions on the liver. I know, as you do, the importance of these two organs, and whenever there is a problem, it is good to follow up.

You mentioned that this was found on a CT when you went to the ER for abdominal pain. Had you any other symptoms prior to that ER visit? I'm thing of digestive tract problems.

Yes, it would be a very good idea to seek a second opinion from a large medical center where they can sort out your symptoms as well as evaluate your CT scan. Large medical centers tend to be more research-oriented and thereby have more resources at their disposal to diagnose and treat problems.

Have you had any other testing done, such as blood work for the liver and pancreas functioning?

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Hi, I wanted to add some things that were also alarming to me. My CBD is now dilated to 13, occult ampullary mass,
right adreanal myeliopoma,elavated LTFs,
Dilated Billary ducts,
Severe pancreas atrophy, cluster of T2 hyper intense foci w/ in pancreatic body, one measuring 3mm in tail,probable right adrenal myelollipoma, IPMN present in pancreas
All of this was from MRCP & Carscans done while I hospitalized for Pancreatic in June & July.
Nothing was done
Newest catscan revealed:
CBD dilated to 14 mm,
Lymphatic System: Mild portacaval adenopathy unchanged.
Bilirubin in Urine, High white blood cell
IPMN & neoplasms found

I do have an appointment with Mayo, Dec 14.:);)

But I like to understand what I’m dealing with.
Again I lost 30 lbs in 7 weeks, zero appetite, upper stomach pain( more on left side and pain radiates to left shoulder pain( feels like stabbing)
Diarrhea every day.
I don’t have any jaundice tho.
I would appreciate all & any comments

Every time I have been hospitalized they kept saying they couldn’t do a biopsy if they needed to because I was always do inflamed- Pancreas

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