Abdominal pain with jaundice

Introduction Abdominal pain with jaundice is one of the symptoms of pancreatic head cancer, which refers to a malignant tumor that occurs in the head of the pancreas. At present, the cause of pancreatic cancer is still unclear, and some environmental factors have been found to be associated with the occurrence of pancreatic cancer. The primary risk factor identified is smoking. Other high-risk factors include diabetes, cholelithiasis, alcohol (including beer), and chronic pancreatitis. Eating a high-fat, high-protein diet and refined flour foods, 20 years after gastrectomy, is also a risk factor for pancreatic cancer.

Cause

Causes

At present, the cause of pancreatic cancer is still unclear, and some environmental factors have been found to be associated with the occurrence of pancreatic cancer. The primary risk factor identified is smoking. Other high-risk factors include diabetes, cholelithiasis, alcohol (including beer), and chronic pancreatitis. Eating a high-fat, high-protein diet and refined flour foods, 20 years after gastrectomy, is also a risk factor for pancreatic cancer.

an examination

Related inspection

Electronic colonoscopy abdominal perspective

The most common clinical manifestations of pancreatic head cancer are abdominal pain, jaundice and weight loss.

(1) Upper abdominal pain and upper abdominal fullness discomfort: is a common first symptom. In the early stage, due to obstruction of the pancreatic duct, the intraluminal pressure is increased, and the upper abdomen is dull and painful, and can be radiated to the lower back. A small number of patients can present severe pain. Most patients do not care about early symptoms, fail to see early, or are ignored, and delay diagnosis. In the advanced stage, the tumor invades the lower and middle segments of the common bile duct, compresses the superior mesenteric vein or portal vein, invades the different segments of the duodenum and the celiac plexus, which aggravates the symptoms of abdominal pain, and even affects sleep and diet, and accelerates physical fitness. Consumption.

(2) Astragalus: It is the most important symptom and sign of pancreatic head cancer. The appearance of jaundice in the morning and evening is related to the location of the cancer in the head of the pancreas. The jaundice appears earlier in the common bile duct area, and the jaundice from the common bile duct appears later. Most patients have advanced jaundice, and the jaundice is progressively aggravated with itchy skin, but some patients may have no itching. The elderly with jaundice may have bleeding tendency. The biliary tract is completely obstructed, the jaundice is deep, and the stool is terracotta; when the depth is yellow, the surface of the stool is dyed light yellow. Physical examination: visible sclera and yellow skin, liver, and most patients with gallbladder enlargement.

(3) weight loss and fatigue: the patient has weight loss, fatigue, weight loss at the beginning, which is related to diet reduction, indigestion, lack of sleep and cancer consumption.

(4) Digestive symptoms: such as loss of appetite, bloating, indigestion, diarrhea or constipation. Some patients may have nausea and vomiting. Advanced cancer invading the duodenum may cause upper gastrointestinal obstruction or gastrointestinal bleeding.

(5) Others: Some patients showed symptoms of mild diabetes at the early stage of the disease, blood sugar increased, and urine sugar was positive. Pancreatic head cancer causes more biliary obstruction without biliary tract infection, a small number of patients can be combined with biliary tract infection, chills and high heat are easily confused with cholelithiasis. In the advanced stage, the patient may have a lumpy upper abdominal mass, which is hard and fixed, and may have ascites.

Physical examination:

Examination of the upper abdomen tenderness and jaundice, when jaundice occurs, often due to cholestasis, hepatomegaly, palpation hard, smooth surface, can be sacred, saclike, no tenderness, smooth surface, and can expand the gallbladder, Calling the Courvisier sign is an important sign for the diagnosis of pancreatic head cancer. Pancreatic masses are more common in the upper abdomen and are nodular or hard masses. They can be tumors themselves or lymph nodes that are metastatic in the abdominal cavity. The mass of cancer of the head of the pancreas is generally deep and inactive, while the metastatic carcinoma of the mesentery or the large net is a certain activity. Patients with advanced stage may have ascites, mostly due to abdominal pancreatic metastasis. A small number of patients may have supraclavicular lymphadenopathy or rectal examination and pelvic metastases.

Differential diagnosis

Differential diagnosis of abdominal pain with jaundice:

Abdominal pain, fever and jaundice: (Charcot) Triad refers to abdominal cramps (high pain in the right upper abdomen), chills fever and jaundice, which are typical symptoms of acute suppurative cholangitis, most of which are bile duct stones. The Charcot triad is a typical manifestation of acute cholangitis.

The most common clinical manifestations of pancreatic head cancer are abdominal pain, jaundice and weight loss.

(1) Upper abdominal pain and upper abdominal fullness discomfort: is a common first symptom. In the early stage, due to obstruction of the pancreatic duct, the intraluminal pressure is increased, and the upper abdomen is dull and painful, and can be radiated to the lower back. A small number of patients can present severe pain. Most patients do not care about early symptoms, fail to see early, or are ignored, and delay diagnosis. In the advanced stage, the tumor invades the lower and middle segments of the common bile duct, compresses the superior mesenteric vein or portal vein, invades the different segments of the duodenum and the celiac plexus, which aggravates the symptoms of abdominal pain, and even affects sleep and diet, and accelerates physical fitness. Consumption.

(2) Astragalus: It is the most important symptom and sign of pancreatic head cancer. The appearance of jaundice in the morning and evening is related to the location of the cancer in the head of the pancreas. The jaundice appears earlier in the common bile duct area, and the jaundice from the common bile duct appears later. Most patients have advanced jaundice, and the jaundice is progressively aggravated with itchy skin, but some patients may have no itching. The elderly with jaundice may have bleeding tendency. The biliary tract is completely obstructed, the jaundice is deep, and the stool is terracotta; when the depth is yellow, the surface of the stool is dyed light yellow. Physical examination: visible sclera and yellow skin, liver, and most patients with gallbladder enlargement.

(3) weight loss and fatigue: the patient has weight loss, fatigue, weight loss at the beginning, which is related to diet reduction, indigestion, lack of sleep and cancer consumption.

(4) Digestive symptoms: such as loss of appetite, bloating, indigestion, diarrhea or constipation. Some patients may have nausea and vomiting. Advanced cancer invading the duodenum may cause upper gastrointestinal obstruction or gastrointestinal bleeding.

(5) Others: Some patients showed symptoms of mild diabetes at the early stage of the disease, blood sugar increased, and urine sugar was positive. Pancreatic head cancer causes more biliary obstruction without biliary tract infection, a small number of patients can be combined with biliary tract infection, chills and high heat are easily confused with cholelithiasis. In the advanced stage, the patient may have a lumpy upper abdominal mass, which is hard and fixed, and may have ascites. Physical examination: examination of upper abdomen tenderness and jaundice, when jaundice occurs, often due to cholestasis, liver is large, palpation is hard, smooth surface, can be saclike, no tenderness, smooth surface, and can be displaced The gallbladder, called the Courvisier sign, is an important sign for the diagnosis of pancreatic head cancer. Pancreatic masses are more common in the upper abdomen and are nodular or hard masses. They can be tumors themselves or lymph nodes that are metastatic in the abdominal cavity. The mass of cancer of the head of the pancreas is generally deep and inactive, while the metastatic carcinoma of the mesentery or the large net is a certain activity. Patients with advanced stage may have ascites, mostly due to abdominal pancreatic metastasis. A small number of patients may have supraclavicular lymphadenopathy or rectal examination and pelvic metastases.

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