Clinical manifestations of pancreatic cancer, pancreatic cancer occurred in the Department of a malignant cancer of the pancreas.
Pancreatic cancer with two kinds of primary and secondary, primary account for the majority; secondary are rare, many of the adjacent organs such as stomach cancer or metastasis from other extensions. Primary human pancreatic cancer accounts for 2% of all cancers to 4%, occur in the pancreatic head (80%), and the remaining in the body or tail.
[Diagnostic points]
A clinical presentation of pancreatic cancer, clinical manifestations
1, the earliest symptoms of abdominal pain, more common in the pancreatic body and tail of pancreas cancer, located in the upper abdomen, Cullen or right upper quadrant, the nature of colic, paroxysmal or persistent, progressive increase of the dull pain, mostly to the spinal back radiation, increased supine and evening, sit, stand, or walk forward position when the pain reduces.
2, jaundice at some stage in the course of the disease may have jaundice, jaundice in pancreatic cancer more generally, see, and signs of early cancer confined to the body and tail more than when no jaundice. Mostly obstructive jaundice, was progressively deepened, with skin itching and other symptoms.
3, about 90% of patients develop rapid and significant weight loss, often accompanied by the late cachexia.
4, fatigue and loss of appetite are very common, can still be accompanied by diarrhea, constipation, bloating, nausea and other gastrointestinal symptoms. Steatorrhea can occur in some patients and high blood sugar, diabetes.
5, due to tumor ulceration or infection, can also be secondary to biliary infection due to fever.
6, part of the pancreas, cancer tail vein visible limb thrombophlebitis, causing partial limb edema.
7, except that jaundice, physical examination, may have upper abdominal tenderness. Late hit on the abdomen can be nodular, hard of mass. Such as jaundice associated with gallbladder enlargement was an important basis for pancreatic cancer. Because cholestasis, and hepatomegaly often palpable. Such as the oppression of splenic vein tumor thrombosis or splenic vein, the palpable splenomegaly.
8, advanced cases there may be ascites, and in the left subclavian or rectal pouch and a hard and palpable lymph node enlargement.
Clinical manifestation of pancreatic cancer the second, auxiliary examination
1, such as the destruction of pancreatic cancer, may appear positive urine and blood food increased.
2, the ESR most growth.
3, the early stage pancreatic duct obstruction, serum amylase and lipase can often higher than normal.
4, when there is obstructive jaundice, can have a direct bilirubin and serum leucine GGT, alkaline phosphatase increased; urine bilirubin increased significantly.
5, gastrointestinal tract X-ray barium meal examination showed pancreatic cancer may be the expansion of the Department of duodenal box; pancreatic body or tail cancer, the greater curvature of the stomach or duodenum or colon Part 3 foreign object the phenomenon of oppression.
6, ERCP, pancreatic duct with irregular bends Code, the limitations of narrow or abruptly. Pancreatic juice collected during the inspection for cytological examination can improve the diagnosis rate.
7, selective abdominal angiography mainly within the pancreas or peripancreatic artery and vein patterns change.
8, CT scans mainly for local mass, pancreatic contour part or all of abnormal expansion of the fat layer around the disappearance of the pancreas.
9, B super can show more than 2cm of pancreatic lesions. Showed the limitations of morphological changes in swelling or in part, leafy. Non-invasive ultrasound examination, and simple and valuable.
10, radionuclide scanning 75Se – methionine, showing that radioactivity was the Department of sparse cancer cold areas.
11, laparoscopic and pancreatic biopsy and cytology, may be direct evidence of pancreatic lesions.
12, duodenum, bile and pancreatic juice drainage fluid examination were reduced. Secretin PZ elements and promote pancreatic exocrine function for the determination of the total found in pancreatic juice and trypsin and bicarbonate were decreased with time.
13, tumor markers such as CEA, pancreatic cancer associated antigen, pancreatic embryonic antigen, carbohydrate antigen CA19-9, Du-PRN-2, etc., the diagnosis of pancreatic cancer is relatively specific.
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