pancreatic cancer Flashcards
most common histology
adenocarcinoma
most common location
head of pancreas
how can pancreatic cancer cause obstructive jaundice
if tumour in head grows big enough it will compress bile ducts
presentation
painless obstructive jaundice
- yellow skin + sclera
- pale stools
- dark urine
- itching
also
- abdo or back pain
- weight loss
- epigastric mass
- change bowel habit
- N/V
- new onset diabetes or worsening of T2DM
when to refer for suspected pancreactic cancer
over 40 w jaundice - 2wk wait referral
over 60 with weihgt loss + additional symtom - direct access CT referral
refer for direct access CT abdo to assess for pancreatic cancer if patient has weight loss plus any of….
diarrhoea back pain abdo pain nausea vomiting constipation new onset diabetes
courvoisier’s law
palpable gallbladder with jaundice is unlikley to be gallstones
–> cholangiocaricnoma or pancreatic cancer
Trousseau’s sign of malignancy
migratory thrombophlembitis - blood vessels inflamed with assoc blood clot
pancreatic adenocarcinoma
Ix
CT
MRPC
ERCP
biopsy
Mx - surgical opitons
total pancreatectomy
distal pancreatectomy
whipple
modified whipple
Mx - when is surgery considered
small tumour isolated to head
Mx - palliative options
stents
surgery
palliative chemo, radio
what is a Whipple
pancreaticduodenectomy
removal of
- head panceras
- stomach pylorus
- duodenum
- gallbladder
- bile duct
- relevant lymph nodes
