Indication of Pancreatic Calcification (21 y.o. female)

Posted by caylynnejames1447 @caylynnejames1447, Oct 30, 2022

For sometime now, I have been seeing a rheumatologist for a high ANA titer with a nuclear, speckled pattern (amongst other indications in blood work that indicate inflammatory processes). More recently, for the past few weeks, I’ve had onset of new symptoms (usually I have joint pain, fatigue, dry eyes + mouth, easy bruising of legs) remedied after round of steroids. New symptoms include upper abdominal pain from the middle to left (spreading into my back and shoulder), extreme nausea, trouble with food + water intake, and weakness. I went to urgent care thinking I picked up the flu or something else, where an X-ray was performed that indicates pancreatic calcification. The next day my rheumatologist confirmed the same finding on the X-ray and pulled blood work. Blood work shows infection: high WBC, high Gran # (ANC), high Gran %, low lymph and mono %). I was instructed to go to the ER by my rheumatologist and gastroenterologist on Friday. Dr in the ER failed to look at recent X-ray, blood work, or any notes from my most recent rheumatology appointment. He ordered a CT with no contrast, which did NOT show pancreatic calcifications. Why is this? Are CT scans without contrast more accurate than a X-ray? What is the possibility I do have chronic pancreatitis, seen by two doctors (one being a rheumatologist) on X-ray, that just isn’t visible on a CT?

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Hi @caylynnejames1447, how frustrating and confusing when getting different opinions from different medical professionals. I found this information for you.

- When is contrast needed for abdominal and pelvic CT?: https://www.ccjm.org/content/87/10/595
"How do you choose CT with or without contrast? In general, when the primary reason for CT is to evaluate the liver, gallbladder, pancreas, spleen, adrenal glands, or urinary tract, oral contrast is unnecessary. Alternatively, when evaluating the gastrointestinal lumen or bowel wall, oral contrast may be beneficial."

It sounds like you should share the results of the CT scan with both your rhematologist and gastroenterologist if that was not already automatically done by the ER doctor. This is certainly something that you want to get answers for.

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