Dilated pancreatic duct: Should I get a second opinion?

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

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

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.

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

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

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/

My husband had dilated bile duct and a 7mm lesion found by MRCP, but EUS test was negative. Could I check if EUS has high false negative and we should seek second opinion and another EUS or ERCP? Recently, there are more symptoms, such as no appetite, feeling full and bloated, and slight loss of weight, probably a couple of pounds in the recent months. Also had diarrhea for no reason for several weeks, but now is gone. Here is the history of the findings:

Nov 30, 2021 Ultrasound: Dilatation of the common bile duct at the porta hepatis measuring 9.6 mm, of uncertain etiology
Jan 31, 2022, MRCP: Minimal dilatation of the common bile duct which abruptly tapers at the distal aspect where there is a questionable 0.7 cm T2 hypointense lesion
Feb 22, 2022, EUS: Mild dilation of common bile duct with tapering to ampulla. No ampullary or ductal lesion is visualized on EUS.
The pancreas is otherwise normal in appearance with a normal pancreatic duct.
April 7, 2022, MRCP: Unchanged mild prominence of the common bile duct at the porta hepatis with smooth tapering distally. Again noted apparent filling defect in the periampullary common bile duct lumen, near the identical to MRI 1/31/2022, would favor artifact given unremarkable ERCP and normal labs in the interim
Aug 30, 2022, MRCP, results pending.

We live in San Diego, California. UCSD and SCRIPPS are two major medical systems in the area. Does anyone know which system is better and more experienced with pancreatic cancer diagnosis and treatment?

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!!

Thank you so much for this information. I actually had some labs done in the ER on July 4th of all days. My doctor has ordered additional labs to see if I am a candidate for iron infusions as my blood counts are not low enough as before when I received transfusions. Because of my dilated liver and pancreatic ducts I have no appetite, frequent nausea and chronic diarrhea. Labs at the ER showed I am under nourished, and honestly I was not surprised. I recently started taking some over the counter remedy for leg cramps and that has helped. I believe I will breathe a little easier once my MCRP is completed in August. It has been a long and frustrating road.

Restless legs and iron anemia go hand in hand. The slow iron supplement is the way to go. If you don't tolerate oral iron, then you can request to visit with a hematologist (blood doctor) who can prescribe IV Iron. I took IV Iron and it really helped me. I get an infusion a year. We figured out the reason for blood loss were my very heavy periods as well as Crohn's disease. Have they figured out why you are iron deficient? Is it because you don't eat iron rich foods, or is it because you are bleeding from somewhere?