ⒸPathologynuggets.blogspot.com Notes to review for medical students, residents, and doctors.
Risk Factors:
Diabetes mellitus, Chronic pancreatitis, Hereditary Pancreatitis, Cigarette Smoking
Courvoisier Sign of Pancreatic Cancer:
Pancreatic cancer has jaundice which is painless, and gallbladder is palpable below right costal margin.
Trousseau Sign of Pancreatic Carcinoma:
It is associated with recurrent migratory thrombophlebitis.
Other findings suggestive of this cancer are:
weight loss, anorexia, dull abdominal pain which is worse at night.
Other important associations include new onset Diabetes Mellitus and non-bacterial thrombotic endocarditis.
Diagnosis:
Imaging by Ultrasonography or CT scan is test of choice. CT Scan shows "double-duct sign". Definitive diagnosis is by biopsy and histologic examination. If these tests are inconclusive, Endoscopic ultrasound or ERCP with brushings/biopsy for histopathology can be done.
Role of CA 19-9 in pancreatic cancer: It does not have a role in screening or diagnosis. It is useful in post-operative monitoring for recurrence.
Other investigations that can be helpful include Liver Function Tests, serum amylase, lipase, complete blood count.
Pancreatic carcinoma is one of the major GI malignancies that requires expert treatment and management.
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