Pancreatic fistula differential diagnosis: Difference between revisions
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==Differentiating Pancreatic fistula from other Diseases== | ==Differentiating Pancreatic fistula from other Diseases== | ||
[[Differential diagnosis]] of a [[pancreatic]] [[fistula]] may include evaluation for:<ref name="pmid25893120">{{cite journal| author=Cochrane J, Schlepp G| title=Acute on chronic pancreatitis causing a highway to the colon with subsequent road closure: pancreatic colonic fistula presenting as a large bowel obstruction treated with pancreatic duct stenting. | journal=Case Rep Gastrointest Med | year= 2015 | volume= 2015 | issue= | pages= 794282 | pmid=25893120 | doi=10.1155/2015/794282 | pmc=4381724 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25893120 }} </ref> | [[Differential diagnosis]] of a [[pancreatic]] [[fistula]] may include evaluation for:<ref name="pmid25893120">{{cite journal| author=Cochrane J, Schlepp G| title=Acute on chronic pancreatitis causing a highway to the colon with subsequent road closure: pancreatic colonic fistula presenting as a large bowel obstruction treated with pancreatic duct stenting. | journal=Case Rep Gastrointest Med | year= 2015 | volume= 2015 | issue= | pages= 794282 | pmid=25893120 | doi=10.1155/2015/794282 | pmc=4381724 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25893120 }} </ref> | ||
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|[[Heart failure]] | |[[Heart failure]] | ||
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* Ankle [[edema]] or swelling of the feet and legs | *Ankle [[edema]] or swelling of the feet and legs | ||
* [[Dyspnea]] on ordinary exertion or greater [[shortness of breath]] with usual activities | *[[Dyspnea]] on ordinary exertion or greater [[shortness of breath]] with usual activities | ||
* [[Confusion]] and [[altered mentation]] | *[[Confusion]] and [[altered mentation]] | ||
* [[Syncope]] | *[[Syncope]] | ||
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*[[Pleural effusion]] with dullness to [[percussion]] at the bases | |||
*[[Jugular vein distention]] | |||
*[[Third heart sound]] (S3) and a gallop rhythm | |||
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*[[Electrolyte disturbances]] such as [[hyponatremia]], [[hypokalemia]], [[hyperkalemia]] and [[hypomagnesemia]] | |||
*[[Anemia]] | |||
*Raised [[natriuretic peptides]] such as [[BNP]] or [[NT-proBNP]] | |||
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|[[Pancreatitis]] | |[[Pancreatitis]] | ||
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* [[Nausea]] and/or [[vomiting]] | |||
* [[Weight loss]] | |||
* [[Jaundice]] | |||
* Pancreatic [[ascites]] | |||
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* [[Jaundice]] | |||
* [[Pallor]] | |||
* [[Bruises]] | |||
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* 72-hour quantitative [[fecal]] [[fat]] | |||
* Fecal [[elastase]] measurement | |||
* [[Pancreatic]] function tests | |||
|- | |- | ||
|[[Retroperitoneal bleeding]] | |[[Retroperitoneal bleeding]] | ||
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* [[Tachycardia]] and [[hypotension]] | |||
* [[Abdominal pain]] | |||
* Intense flank pain or [[back pain]] | |||
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* [[Grey Turner's sign|Grey-Turner's sign]] with bulging flanks | |||
* [[Pallor]] | |||
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* [[Anemia]] | |||
|- | |- | ||
|[[Bowel ischemia]] | |[[Bowel ischemia]] | ||
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* [[Abdominal pain|Abdominal Pain]] | |||
* [[Vomiting]] | |||
* [[Diarrhea]] | |||
* [[Constipation]] | |||
* Blood per [[rectum]] | |||
* [[Abdominal distension|Abdominal distention]] | |||
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* [[Abdominal distension|Abdominal distention]] | |||
* Generalized [[Abdominal tenderness]] | |||
* [[Rebound tenderness]] | |||
* [[Guarding]] may be present | |||
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* [[Leukocytosis]] | |||
* [[Hyperphosphatemia]] | |||
* [[Hyperkalemia]] | |||
* [[High anion gap metabolic acidosis]] | |||
|- | |- | ||
|[[pleural effusion]] | |[[pleural effusion]] | ||
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* [[Chest pain]], usually a sharp pain that is worse with cough or deep breaths | |||
* [[Cough]] | |||
* [[Rapid breathing]] | |||
* [[Shortness of breath]] | |||
* [[Orthopnea]] | |||
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* Asymmetric chest expansion | |||
* Diminished [[fremitus]], dullness on [[percussion]] | |||
* Decreased or absent [[breath sounds]] | |||
* Reduced vocal resonance | |||
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* Appearance of fluid: milky, bloody, or clear | |||
* Culture | |||
* Cytology | |||
* [[Antinuclear antibody]] ([[ANA]]) >1 (systemic lupus erythematosus) | |||
* [[Amylase]] and severe [[acidosis]] ([[esophageal rupture]]) | |||
* [[Triglycerides]] (>110mg/dL = chylothorax) | |||
* [[Hematocrit]] (pleural fluid to blood >0.5) | |||
* [[Glucose]] 300 to 400 ([[peritoneal dialysis]]) | |||
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Revision as of 05:44, 28 April 2021
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Pancreatic fistula Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Pancreatic fistula differential diagnosis On the Web |
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American Roentgen Ray Society Images of Pancreatic fistula differential diagnosis |
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Risk calculators and risk factors for Pancreatic fistula differential diagnosis |
Overview
Differential diagnosis of pancreatic fistula may include chronic liver disease, renal failure, heart failure, malignancy, pleural effusion, pancreatitis, retroperitoneal bleeding and bowel ischemia.
Differentiating Pancreatic fistula from other Diseases
Differential diagnosis of a pancreatic fistula may include evaluation for:[1]
| Diseases | Symptoms | Physical examination | Lab Findings |
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| Chronic liver disease |
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| Renal failure |
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| Heart failure |
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| Pancreatitis |
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| Retroperitoneal bleeding |
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| Bowel ischemia |
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| pleural effusion |
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References
- ↑ Cochrane J, Schlepp G (2015). "Acute on chronic pancreatitis causing a highway to the colon with subsequent road closure: pancreatic colonic fistula presenting as a large bowel obstruction treated with pancreatic duct stenting". Case Rep Gastrointest Med. 2015: 794282. doi:10.1155/2015/794282. PMC 4381724. PMID 25893120.