The pancreas is an organ in the abdomen (). It is responsible for producing digestive juices and certain hormones, including insulin, which is responsible for. WebMD provides a historical overview of the AIDS pandemic from the first human case to the present. TB can also spread to other parts of the body, such as the brain, spine, bladder and. A description of the TB test and what results mean (part of the Just Diagnosed program), from the VA National HIV/AIDS website. Pancreatic Cancer Symptoms, Treatment, Causes - What are pancreatic cancer symptoms and signs? What are pancreatic cancer symptoms and signs? Because the pancreas lies deep in the belly in front of the spine, pancreatic cancer often grows silently for months before it is discovered. Early symptoms and/or first signs can be absent or quite subtle. More easily identifiable symptoms develop once the tumor grows large enough to press on other nearby structures, such as nerves (which causes pain), the intestines (which affects appetite and causes nausea along with weight loss), or the bile ducts (which causes jaundice or a yellowing of the skin and can cause loss of appetite and itching). Symptoms in women rarely differ from those in men. Once the tumor sheds cancer cells into the blood and lymph systems and metastasizes, additional symptoms usually arise, depending on the location of the metastasis. Frequent sites of metastasis for pancreatic cancer include the liver, the lymph nodes, and the lining of the abdomen (called the peritoneum). Unfortunately, most pancreatic cancers are found after the cancer has grown or progressed beyond the pancreas or has metastasized to other places. In general, the signs and symptoms of pancreatic cancer can be produced by exocrine or endocrine cancer cells. Exocrine pancreatic cancer signs and symptoms can includejaundice,dark urine,itchy skin,light- colored stools,pain in the abdomen or the back,poor appetite and weight loss,digestive problems (pale and/or greasy stools, nausea, and vomiting),blood clots,enlarged gallbladder. The signs and symptoms of endocrine pancreatic cancers are often related to the excess hormones that they produce and consequently to a variety of different symptoms. Such symptoms are related to the hormones and are as follows: Insulinomas: Insulin- producing tumors that lower blood glucose levels can cause low blood sugars, weakness, confusion, coma, and even death. Glucagonomas: Glucagon- producing tumors can increase glucose levels and cause symptoms of diabetes (thirst, increased urination, diarrhea and skin changes, especially a characteristic rash termed necrolytic migratory erythema). Gastrinomas: Gastrin- producing tumors trigger the stomach to produce too much acid, which leads to ulcers, black tarry stools, and anemia. Somatostatinomas: Somatostatin- producing tumors result in other hormones being overregulated and producing symptoms of diabetes, diarrhea, belly pain, jaundice, and possibly other problems. VIPomas: These tumors produce a substance called vasoactive intestinal peptide (VIP) that may cause severe watery diarrhea and digestive problems along with high blood glucose levels. PPomas: These tumors produce pancreatic polypeptide (PP) that affects both endocrine and exocrine functions, resulting in abdominal pain, enlarged livers, and watery diarrhea. Carcinoid tumors: These tumors make serotonin or its precursor, 5- HTP, and may cause the carcinoid syndrome with symptoms of flushing of the skin, diarrhea, wheezing, and a rapid heart rate that occurs episodically; eventually, a heart murmur, shortness of breath, and weakness develop due to damage to the heart valves. Nonfunctioning neuroendocrine tumors don't make excess hormones but can grow large and spread out of the pancreas. Symptoms then can be like any of the endocrine pancreatic cancers described above. How is the diagnosis of pancreatic cancer made? Most people do not need to be screened for pancreatic cancer. Those who may qualify usually have a set of factors that increase the risk for pancreatic cancer, such as pancreatic cysts, first- degree relatives with pancreatic cancer, or a history of genetic syndromes associated with pancreatic cancer. Most screening tests consist of CT scans, ultrasounds, magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), or endoscopic ultrasounds. Most people with pancreatic cancer first go to their primary- care doctor complaining of nonspecific symptoms (see symptoms section above). Marshall and Warren established that H. The bug seemed to cause about half of stomach ulcers, and 90 %. Gastritis Definition Gastritis commonly refers to inflammation of the lining of the stomach, but the term is often used to cover a variety of symptoms resulting from. Tuberculosis (TB) is responsible for the deaths of more youths and adults than any other infectious disease. Tuberculosis is a highly contagious disease characterized. The revolutionary Dukan Diet Plan – eat as much as you want! Find out what it is, how it compares with other healthy weight loss plans and who created it. Some warning signs include pain, gastrointestinal symptoms, weight loss, fatigue, and increased abdominal fluid. These complaints trigger an evaluation often including a physical examination (usually normal), blood tests, X- rays, and an ultrasound. If pancreatic cancer is present, the likelihood of an ultrasound revealing an abnormality in the pancreas is about 7. If a problem is identified or suspected, frequently a computed tomography (CT) scan is performed as the next step in the evaluation. A pancreatic mass and the suspicion of pancreatic cancer is then raised and a biopsy is performed to yield a diagnosis. Different strategies can be used to perform a biopsy of the suspected cancer. Often, a needle biopsy of the liver through the belly wall (percutaneous liver biopsy) will be used if it appears that there has been spread of the cancer to the liver. If the tumor remains localized to the pancreas, biopsy of the pancreas directly usually is performed with the aid of a CT. A direct biopsy also can be made via an endoscope put down the throat and into the intestines. A camera on the tip of the endoscope allows the endoscopist to advance the endoscope within the intestine. An ultrasound device at the tip of the endoscope locates the area of the pancreas to be biopsied, and a biopsy needle is passed through a working channel in the endoscope to obtain tissue from the suspected cancer. Ultimately, a tissue diagnosis is the only way to make the diagnosis with certainty, and the team of doctors works to obtain a tissue diagnosis in the easiest way possible. In addition to radiologic tests, suspicion of a pancreatic cancer can arise from the elevation of a . The tumor marker most commonly associated with pancreatic cancer is called the CA 1. It is often released into the bloodstream by pancreatic cancer cells and may be elevated in patients newly found to have pancreatic cancer. Unfortunately, the CA 1. Other cancers as well as some benign conditions can cause the CA 1. Sometimes (about 1. CA 1. 9- 9 will be at normal levels in the blood despite a confirmed diagnosis of pancreatic cancer, so the tumor marker is not perfect. It can be helpful, however, to follow during the course of illness since its rise and fall may help guide appropriate therapy. Medically Reviewed by a Doctor on 2/2. Non- Cancerous Liver Lesions . These liver masses are usually benign (non- cancerous) in patients without underlying liver disease and usually need no specific treatment. We recommend that the work- up and management of benign lesions be overseen by a multidisciplinary team including radiologists, hepatologists, oncologists and surgeons - which exists at California Pacific Medical Center - to ensure a patient receives the best possible care. Benign masses can be categorized into two groups: solid or cystic (fluid filled). Solid Masses. . Among the most common solid masses include: Hemangioma. Focal nodular hyperplasia. Adenoma. Focal fatty change. Nodular regenerative hyperplasia. Hemangiomas are the most common of all benign liver masses. They are more prevalent in women and may be affected by hormonal changes. Symptoms such as pain are mostly noted in lesions less than 6 cm and are related to compression of adjacent structures. Bleeding is rare. Diagnosis of these lesions is usually made radiologically with magnetic resonance imaging (MRI) offering the most definitive means of diagnosis. No specific treatment is required for asymptomatic lesions whatever the size. Surgical resection is the treatment of choice for symptomatic lesions. Focal Nodular Hyperplasia (FNH) is the second most common benign lesion of the liver. It is usually asymptomatic and has no malignant potential or risk of rupture. Symptomatic lesions are usually larger and cause compression of adjacent structures. Laboratory studies are usually normal and diagnosis is made radiologically. At times a biopsy may be needed. Surgical resection is indicated only if the diagnosis is of question or the patient is symptomatic. Adenomas are a rare entity and have a strong association with oral contraceptive use. Larger adenomas (less than 5 cm) may present with abdominal discomfort or a feeling of fullness. Other symptoms include nausea, vomiting and fevers. Larger lesions have a tendency to bleed (4. Diagnosis of these lesions is made by a combination of radiographic examinations and sometimes biopsy. Treatment should consist of first discontinuing oral contraception use and then radiographic follow up. Additionally, all lesions less than 4 - 5 cm or where malignancy cannot be excluded should be surgically resected. Focal Fatty Change occurs when fat distribution within the liver is not evenly spread. Areas of increased fat accumulation are referred to as focal fatty change. Patients who have a history of diabetes, obesity, hepatitis C or malnutrition may be predisposed to this condition. Individuals are usually asymptomatic. These lesions are diagnosed by radiographic examination (MRI) and at times require a biopsy. No specific treatment is required. Cystic Masses. . Two major categories of cystic masses exist and are related to either an infectious or a non- infectious cause. Non- Infectious Cystic Masses. Bile Duct (Choledochal) Cysts may be present from birth (congenital) or may arise later in life. There appears to be a higher incidence of this process in females. Adult onset choledochal cysts are usually an incidental finding. If symptomatic, the patient may present with pain under the right rib cage, nausea, vomiting, fever and/or jaundice. In extreme cases, a patient may present with back pain. Patients may rarely present with inflammation of the liver and sometimes cirrhosis of the liver due to chronic obstruction of the bile duct. In addition to laboratory studies, a variety of imaging modalities may be needed. More invasive studies by a gastroenterologist or an interventional radiologist are required to fully delineate the extent of the disease process. Biopsy of the bile duct may be needed to rule out bile duct cancer. The presence of cancer may be known either before or at the time of the operation. The operation consists of resecting the diseased bile duct and reconnecting the remnant to the small intestine. A transplant evaluation is needed if liver cirrhosis is noted on the preoperative workup. A simple liver cyst is usually a single cyst located within the liver, which is present from birth. Most cysts are asymptomatic and are uncommonly diagnosed before age 4. If symptomatic, patients complain of abdominal fullness and pain. Diagnosis is made radiographically. No specific treatment is needed in cases where the cyst is greater than 8 cm in diameter or is within the confines of liver tissue. Infectious or cancerous causes as well as possible communication with the bile duct system must be ruled out prior to performing an operation. Smaller symptomatic cysts may be needle aspirated to determine if symptoms improve prior to a definitive procedure. Marsupialization (widely opening the cyst to drain into the abdominal cavity) is the approach of choice. In certain cases, the location of the cyst may preclude marsupialization and may require a partial liver resection. Polycystic Liver Disease (PCLD) is an inherited condition and may be associated with cystic lesions of the kidneys. Most patients are asymptomatic with normal laboratory studies. The liver cysts are multiple and tend to enlarge slowly. Symptoms are similar to that of simple cysts. Ultrasound and CT scans are reliable in detecting the lesions. These cysts must be differentiated from multiple simple cysts given that PCLD is an inherited disease. There are genetic tests available to help counsel afflicted patients and families. Treatment for PCLD is similar to the treatment of simple cysts. A liver, kidney or combined liver- kidney transplant may be necessary depending on disease severity of the organs afflicted. Infectious Cystic Masses. Pyogenic Liver Abscesses (bacterial cause) - There are numerous causes of bacterial infections that bring about abscess formation in the liver. Presently, disease processes within the bile duct that cause bile flow obstruction are the most common cause of pyogenic abscesses. Other causes include intra- abdominal infections (i. Finally, distant infectious processes such as dental abscesses and endocarditis may cause liver abscess formation. A specific source is not identified in up to 5. Patients can present with fevers, chills, nausea, vomiting, abdominal pain and loss of appetite. Some may present with a severe illness if rupture of the abscess into the abdominal cavity has occurred. The diagnosis can be made with a combination of history and physical examination, laboratory studies and radiologic examination. Treatment depends on the clinical condition of the patient and radio- logic findings. Typically, antibiotic therapy is initiated and the abscess is drained using a catheter placed directly into the abscess by the radiologist (9. Amebic Liver Abscess - Amebic infection or amebiasis is a common infection in the tropics. In the United States individuals at risk for amebiasis are those who have immigrated from or traveled to endemic areas. The organism responsible for the disease process is Entamoeba Histolytica. Transmission usually occurs via ingestion of infected water. Liver abscess formation occurs when the ameba penetrates through the intestines and into local veins that drain into the liver. Liver abscesses are more common in patients who are immunocompromised, malnourished or have a malignancy. Less than one- third of the patients have intestinal symptoms prior to the diagnosis of liver abscess. Patients usually present with acute abdominal pain and fevers. Up to 8% of patients present with mild jaundice. Tests to detect antibodies in the blood (positive in up to 9. Various radiologic studies can be used to help in the diagnosis. Treatment is primarily with antibiotics. Aspiration of the abscess is rarely indicated. An operation is indicated if worsening infection is noted despite adequate medical therapy. Hydatid Cysts - These liver cysts are caused by a parasitic organism found in dogs. Echinococcus granulosus or Echinococcus multilocularis are parasites (tapeworms) that infect dogs. Tapeworm embryos are present in the feces of dogs. After inadvertent ingestion, the tapeworm embryo will penetrate the intestine and usually find its way to the liver. It may also migrate to other structures such as the lung, spleen, brain, bone or kidney after entering the bloodstream. Cysts are usually visible three weeks after ingestion and continue to secrete fluid causing compression of the liver. Cysts less than 5 cm are usually asymptomatic and no specific treatment is required. Patients usually have symptoms of abdominal fullness. Pain usually is noted when cysts get infected or rupture. The most common site of rupture is into the bile ducts within the liver causing symptoms of bile duct obstruction and infection. Some patients may present with an allergic reaction after cyst rupture. Radiologic studies used to diagnose hydatid cysts are ultrasound and CT scans. Antibody tests are available to detect hydatid cysts and should be completed. Treatment options range from chemotherapy (mebendazole and albendazole) to surgery. Surgery can entail a conservative approach (various drainage type procedures) or a radical operation that removes the entire cyst with a rim of normal liver. Research. . Our Hepatology Research Center has a comprehensive clinical research program, offering concurrent trials for various liver diseases. We also have a Liver Immunology Laboratory that serves as a hub for collaborative viral hepatitis research in the Bay Area. We are proud to be at the forefront of advances and research affecting our patients. Multiple pharmaceutical studies and clinical research trials using new, ground- breaking medications and procedures in the area of viral hepatitis, liver cancer, gastroenterology and liver transplantation are continually being pursued in our Research Center. Hepatology and gastroenterology study locations are available throughout Northern California, with sites in San Francisco, Oakland and Sacramento. View our current liver cancer clinical trials.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
October 2017
Categories |