Overdiagnosis of chronic pancreatitis. MCSC patient history
NewsTo the Department pathologies of the pancreas and biliary tract MCSC was contacted by Patient A., 50 years old.
Since 2014, she began to worry intense pain (2-4 times a year) in upper abdomen.
She repeatedly underwent examination and treatment. Doctors rated pain attacks as exacerbation of chronic pancreatitis "this one diagnosis and was delivered to the patient.
In September 2020, she already had constant pain in the upper abdomen. She accepted painkillers, enzymes but nothing didn't help.
Then in February-April 2021, the patient underwent comprehensive examination in his clinic:
* MRI and MSCT with intravenous contrast,
* CT enterography,
* endoscopic ultrasonography.
She had hemangiomas and a cyst of the liver, heterogeneity of the pancreatic tissue. At the same time signs of post-inflammatory and volumetric formations in the abdominal cavity was not detected.
The patient was again treated in the hospital, she was assigned weak narcotic analgesics.
But the pain is still persisted. In September 2021, the patient received a referral to the MCSC with a diagnosis of: chronic pancreatitis, painful form, continuously recurrent course for examination and possibly, surgical treatment.
In consultation with our specialists, she also complained on:
* persistent nausea,
* bitterness in the mouth,
unstable stool-alternation of constipation up to 3-4 days and stool up to 2 times without admixture of blood and mucus,
* bloating and rumbling in the stomach.
Clinical and biochemical Analyses blood, insulin, C-peptide, pancreatic elastase levels were within normal limits, oncomarkers not promoted. It spoke of satisfactory functions of the pancreas.
As a result, during a comprehensive examination, it became clear that no reason assume the presence of the patient chronic pancreatitis.
Results MSCT it was also shown that the size of the pancreas, its structure not changed.
However, according to the X-ray examination upper digestive tract and colon. signs of motor disorders of the duodenum and colon, omission of the stomach and transverse colon.
The patient consulted neurologist which suggested signs of somatoform dysfunction of the autonomic nervous system and recommended reception antidepressants.
Treatment helped, pain significantly decreased nausea and bitterness in the mouth passed, chair normalized. Now the patient feels good, she is recommended continue therapy.
Thus, diagnosis severe damage to the pancreas not confirmed. Surgical treatment no need.
Through effort a multidisciplinary team the patient was able to return to normal life.
