Ask a doctor on the topic of Internal medicine

Uncertainty after CT and prolonged symptoms

May 20, 2018 | 30,00 EUR | answered by Dr. med. Frauke Gehring

Hello dear medical team,
About me: male; 25 years old; 1.74m; 57kg; non-smoker (for 2 years) / do not drink alcohol (for 1 year).
For the past year, I have been experiencing recurrent upper abdominal symptoms in the center, slight nausea, minimal pain, bloating, and changes in stool (lighter/gray).
Blood work and ultrasound were normal. Colonoscopy was also normal.
An abdominal CT scan showed the following:
"There is a significantly enlarged pancreas with a somewhat smoothed outer contour, which, however, takes up contrast agent homogeneously, suggesting the presence of edematous pancreatitis. There are no pathologically surrounding fluid collections."

My question:
My primary care physician said everything seems to be fine and no further action is needed.
A second opinion suggests that my symptoms may be more indicative of autoimmune pancreatitis.
What can I do now to get a definitive diagnosis?
Is an enlarged pancreas equivalent to an enlarged pancreatic duct, which would have a significantly increased risk of cancer?

Thank you for your time.

Dr. med. Frauke Gehring

Hello,

No, an enlarged pancreas is a thickened organ, an extension of the duct would be described separately. Since the pancreas is located in the back and can cause pain there, it cannot be responsible for your upper abdominal pain. In cases of autoimmune pancreatitis, inflammation markers, amylase, lipase, and rheumatic antibodies are elevated and should be tested.

I would recommend looking for food intolerances and considering irritable bowel syndrome for your symptoms.

Wishing you all the best and a happy Pentecost!

Warm regards, Dr. Gehring