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symptoms of periampullary cancer, early symptoms and signs of periampullary cancer

symptoms of periampullary cancer, early symptoms and signs of periampullary cancer

Periampullary cancer symptoms

Early symptoms: Jaundice appears earlier, progressively worsens, or fluctuates aundice. Jaundice is obstructive, yellowish skin and mucous membranes are more obvious, often accompanied by skin itching. Upper abdominal pain is often the first symptom.

Late symptoms: touch the enlarged liver and gallbladder, the liver texture is hard and smooth. A small number of patients have biliary cirrhosis and splenomegaly due to long-term jaundice. Black stools appear in the late stage, and secondary anemia. Ascites can occur with cancer peritoneal metastasis or portal vein metastasis.

Related symptoms: Cold, cyst, hepatomegaly, itchy skin, high fever, loss of appetite

Diagnosis of periampullary cancer symptoms

A) Symptoms

The age of onset is mostly 40 to 70 years old, and most of them are men. The clinical manifestations of pancreatic head cancer are very similar. The main manifestations are jaundice, epigastric pain, fever, weight loss, hepatomegaly, and gallbladder enlargement. 70% of pancreatic cancers occur in the head of the pancreas, half of the patients only see a doctor 3 months after they have symptoms, and 10% do not see a doctor until more than 1 year.

1. Jaundice

It appears earlier, simultaneously or successively with abdominal pain, and is progressively aggravated. However, a small number of patients may subside or reduce the jaundice due to tumor necrosis and bile duct recanalization, but it deepens again later and presents fluctuating jaundice. Obstructive jaundice, yellowish skin and mucous membranes are more obvious, may be dark green, often accompanied by skin itching. Jaundice is mostly persistent. A small number of patients may subside or lessen due to tumor necrosis and bile duct recanalization, but they will deepen later and present fluctuating jaundice. Progressive aggravation of jaundice is a late stage manifestation. Note that it should not be mistaken for cholelithiasis or hepatocellular jaundice. There may be dark urine, light feces, and bile salts sinking under the skin to stimulate the nerves and cause itching of the skin.

2. Abdominal pain

Upper abdominal pain is seen in 3/4 of cases and is often the first symptom. In the early stage, some patients (about 40%) may increase the intraluminal pressure due to the expansion of the common bile duct or obstruction of the drainage of pancreatic juice, resulting in dull pain under the xiphoid process. Abdominal pain can radiate to the back, often after eating, in the evening, at night or in a fatty meal It worsens later, but not as serious as pancreatic head cancer. In the early stage, some patients have dull pain under the xiphoid process, which can radiate to the back. It is more obvious after eating and is often ignored. Later, due to the expansion of cancer infiltration, or accompanied by inflammation, the pain aggravates, and back pain occurs.

3. Intermittent chills and fever

It is often caused by tumor rupture, cholestasis, and biliary tract infection. It is characterized by repeated sudden cessation, transient high fever accompanied by chills, elevated white blood cells, and even toxic shock. Clinically, it is easy to be misdiagnosed as cholangitis and cholelithiasis, and antibiotics and hormone treatment are ineffective.

4. Digestive symptoms

Due to the lack of bile and pancreatic juice in the intestine, it often causes digestion and absorption disorders, mainly manifested as loss of appetite, fullness, indigestion, fatigue, diarrhea or steatorrhea, gray stools, and weight loss. Due to chronic bleeding after partial necrosis of ampullary carcinoma, melena, fecal occult blood test was positive, and secondary anemia occurred. Ascites can occur with cancer peritoneal metastasis or portal vein metastasis.

5. Enlarged liver and gallbladder

It is caused by bile duct obstruction and bile stasis. The enlarged liver and gallbladder are often palpable. The liver is hard and smooth. In the advanced stage, cancer of the head of the pancreas can often find irregular and fixed masses. A small number of patients have biliary cirrhosis and splenomegaly due to long-term jaundice.

Two) Diagnosis

A preliminary diagnosis can be made if the patient has progressive, nearly painless jaundice, enlarged liver and gallbladder.

1. Clinical manifestations.

2. Laboratory and other auxiliary examinations.

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