Condition Info - BotMed Application

ConditionName

Pancreatic cancer

ConditionDescription

Symptoms

Ab pain radiating to the back;
Jaundice, painless;
Weight loss;
Dark urine, white stool;
Itchy skin;
Abdominal mass;

PhysicalFindings

Migratory superficial venous thromboembolism (Trousseau’s syndrome);
Left supraclavicular lymphadenopathy (Virchow’s node), 
Periumbilical lymph (Sister Mary Joseph’s node);
Splenomegaly;
Palpable not tender GB (Courvoisier sign);
Palpable deep ab mass.

ClinicalTests

ALP elevated;
CA 19-9 elevated – not specific, not elevated with small tumor;

Tumor markers:
↑CEA;
↑Bilirubin conjugated (direct)
↑ALP and ↑GGT;
Mild elevation AST/ALT;

Ab US -> duct dilation (double duck sign), not diagnostic. 
Contract CT is diagnostic;

Insulinoma: ↑fasting insulin; ↑c-peptide;

Glucagonoma:

RiskFactors

Cystic fibrosis;
Family history;
Chronic pancreatitis;
Diabetes; 
Tobacco use;
High fat diet;
Male>female;
Obesity;
Sedentary lifestyle.

IsRedFlag

IsNPLEX

Consequence

Death; 5 y survival < 2%

ProgressionFromCondition

Alcohol abuse;
Gall stone blockage;

TreatmentOptions

Stop smoking;
Pancreatic enzymes;
Probiotics;
Reduce alcohol intake;
Water intake;
Good diet;
Supplementation of fat soluble vitamins;

PharmOptions

WebLink

https://www.merckmanuals.com/en-ca/professional/gastrointestinal-disorders/tumors-of-the-gastrointestinal-tract/pancreatic-cancer