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What Do My Ultrasound And CAT Scan Test Reports Indicate?
Question: I had an ultrasound and a catscan while in the hospital before a cardiac ablation procedure.
The US and CS showed a 5mm dilation of pancreatic duct but no evidence of mass. I've been reading some articles online that a dilated pancreatic duct is almost always because you have chronic pancreatitis or either have or at high risk for pancreatic cancer. My GI is out of town but the doctor coverng for him said not to worry because CT showed no mass. I'm still not convinced this is nothing. Can you point me in a direction so I can read reliable information regarding this?
The US and CS showed a 5mm dilation of pancreatic duct but no evidence of mass. I've been reading some articles online that a dilated pancreatic duct is almost always because you have chronic pancreatitis or either have or at high risk for pancreatic cancer. My GI is out of town but the doctor coverng for him said not to worry because CT showed no mass. I'm still not convinced this is nothing. Can you point me in a direction so I can read reliable information regarding this?
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The main pancreatic duct diameter might be accepted as normal if it measures up to 3.5 mm. The usual upper limit is 2 mm and beyond 2.5 mm the cause requires investigation.
2. The causes of main pancreatic duct dilatation are acute pancreatitis, chronic pancreatitis, cancer of pancreas and tumoral hypersecretion of mucin. In other words there is suspected stricture or obstruction to the flow of the secretions.
3. Any one would get worried about it but since there is no mass identified on CT scan therefore you might relax and the possibility of an aggressive cancer of pancreas is ruled out. However, I would suggest you please wait for the GI doctor to return and get pancreas functions tested in detail.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The main pancreatic duct diameter might be accepted as normal if it measures up to 3.5 mm. The usual upper limit is 2 mm and beyond 2.5 mm the cause requires investigation.
2. The causes of main pancreatic duct dilatation are acute pancreatitis, chronic pancreatitis, cancer of pancreas and tumoral hypersecretion of mucin. In other words there is suspected stricture or obstruction to the flow of the secretions.
3. Any one would get worried about it but since there is no mass identified on CT scan therefore you might relax and the possibility of an aggressive cancer of pancreas is ruled out. However, I would suggest you please wait for the GI doctor to return and get pancreas functions tested in detail.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I guess I am concerned because I've been HIV positive for 20 years and blood work is done every 3 months so I don't think I've had pancreatitis (either chronically or acutely) but maybe its not so cut and dry. If that is the case however, that seems to leave either cancer or a pre-cancerous condition, either one of which means that this will always be a concern, something that will have to be watched constantly.
I'm wondering if you know of anything in the literature (that you could point me to) whereby a group of patients who have similar scans showing dilation of the duct (without a visible mass) are studied and what percentage of them end up having cancer or getting cancer after a certain amount of time. I recall reading of one such study (which online I realize is dicey, you really cannot believe half of what you read online and one word misread could mean a completely erroneous interpretation, like the estrogen study whereby the risk of cancer was doubled for women on hormones, but it was something ridiculously small, like 4 percent versus 2 percent) in which it appeared to my limited understanding that there was a study of 94 such patients and if they didn't have pancreatitis all either had cancer or developed it within 4 years.
Of course, I understand this conversation is limited, you don't have my health history, but am I over-reacting to this? I am meeting with my GI doctor next week, but I'm wondering if I need to consult with an oncologist. THANK YOU for your help! JB
I'm wondering if you know of anything in the literature (that you could point me to) whereby a group of patients who have similar scans showing dilation of the duct (without a visible mass) are studied and what percentage of them end up having cancer or getting cancer after a certain amount of time. I recall reading of one such study (which online I realize is dicey, you really cannot believe half of what you read online and one word misread could mean a completely erroneous interpretation, like the estrogen study whereby the risk of cancer was doubled for women on hormones, but it was something ridiculously small, like 4 percent versus 2 percent) in which it appeared to my limited understanding that there was a study of 94 such patients and if they didn't have pancreatitis all either had cancer or developed it within 4 years.
Of course, I understand this conversation is limited, you don't have my health history, but am I over-reacting to this? I am meeting with my GI doctor next week, but I'm wondering if I need to consult with an oncologist. THANK YOU for your help! JB
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. There are few possibilities in your case other than a cancer, that might cause dilated main pancreatic duct.
2. HIV cholangitis is a condition in which there might be inflammation of biliary channels and leading to strictures. There might also be a stricture at ampulla which is the opening of bile duct and this might cause dilatation of the main pancreatic duct.
3. There is an investigation called endoscopic retrograde cholangio pancreatograpy ERCP and this might be an useful tool to do detailed investigation. Let us wait until your GI doctor returns and probably he might have some options for you next week. Should he direct then you might consult the oncologist.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. There are few possibilities in your case other than a cancer, that might cause dilated main pancreatic duct.
2. HIV cholangitis is a condition in which there might be inflammation of biliary channels and leading to strictures. There might also be a stricture at ampulla which is the opening of bile duct and this might cause dilatation of the main pancreatic duct.
3. There is an investigation called endoscopic retrograde cholangio pancreatograpy ERCP and this might be an useful tool to do detailed investigation. Let us wait until your GI doctor returns and probably he might have some options for you next week. Should he direct then you might consult the oncologist.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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