Pancreatic fistula differential diagnosis: Difference between revisions
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Differential diagnosis of [[pancreatic]] [[fistula]] may include [[chronic liver disease]], [[Renal failure, chronic|renal failure,]] [[heart failure]], [[malignancy]], [[pleural effusion]], [[pancreatitis]], [[retroperitoneal bleeding]] and [[bowel ischemia]]. | Differential diagnosis of [[pancreatic]] [[fistula]] may include [[chronic liver disease]], [[Renal failure, chronic|renal failure,]] [[heart failure]], [[malignancy]], [[pleural effusion]], [[pancreatitis]], [[retroperitoneal bleeding]] and [[bowel ischemia]]. | ||
==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><ref name="pmid17898101">{{cite journal| author=Meyer TW, Hostetter TH| title=Uremia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 13 | pages= 1316-25 | pmid=17898101 | doi=10.1056/NEJMra071313 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17898101 }}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
| Line 64: | Line 64: | ||
|[[Pancreatitis]] | |[[Pancreatitis]] | ||
| | | | ||
* [[Nausea]] and/or [[vomiting]] | *[[Nausea]] and/or [[vomiting]] | ||
* [[Weight loss]] | *[[Weight loss]] | ||
* [[Jaundice]] | *[[Jaundice]] | ||
* Pancreatic [[ascites]] | *Pancreatic [[ascites]] | ||
| | | | ||
* [[Jaundice]] | *[[Jaundice]] | ||
* [[Pallor]] | *[[Pallor]] | ||
* [[Bruises]] | *[[Bruises]] | ||
| | | | ||
* 72-hour quantitative [[fecal]] [[fat]] | *72-hour quantitative [[fecal]] [[fat]] | ||
* Fecal [[elastase]] measurement | *Fecal [[elastase]] measurement | ||
* [[Pancreatic]] function tests | *[[Pancreatic]] function tests | ||
|- | |- | ||
|[[Retroperitoneal bleeding]] | |[[Retroperitoneal bleeding]] | ||
| | | | ||
* [[Tachycardia]] and [[hypotension]] | *[[Tachycardia]] and [[hypotension]] | ||
* [[Abdominal pain]] | *[[Abdominal pain]] | ||
* Intense flank pain or [[back pain]] | *Intense flank pain or [[back pain]] | ||
| | | | ||
* [[Grey Turner's sign|Grey-Turner's sign]] with bulging flanks | *[[Grey Turner's sign|Grey-Turner's sign]] with bulging flanks | ||
* [[Pallor]] | *[[Pallor]] | ||
| | | | ||
* [[Anemia]] | *[[Anemia]] | ||
|- | |- | ||
|[[Bowel ischemia]] | |[[Bowel ischemia]] | ||
| | | | ||
* [[Abdominal pain|Abdominal Pain]] | *[[Abdominal pain|Abdominal Pain]] | ||
* [[Vomiting]] | *[[Vomiting]] | ||
* [[Diarrhea]] | *[[Diarrhea]] | ||
* [[Constipation]] | *[[Constipation]] | ||
* Blood per [[rectum]] | *Blood per [[rectum]] | ||
* [[Abdominal distension|Abdominal distention]] | *[[Abdominal distension|Abdominal distention]] | ||
| | | | ||
* [[Abdominal distension|Abdominal distention]] | *[[Abdominal distension|Abdominal distention]] | ||
* Generalized [[Abdominal tenderness]] | *Generalized [[Abdominal tenderness]] | ||
* [[Rebound tenderness]] | *[[Rebound tenderness]] | ||
* [[Guarding]] may be present | *[[Guarding]] may be present | ||
| | | | ||
* [[Leukocytosis]] | *[[Leukocytosis]] | ||
* [[Hyperphosphatemia]] | *[[Hyperphosphatemia]] | ||
* [[Hyperkalemia]] | *[[Hyperkalemia]] | ||
* [[High anion gap metabolic acidosis]] | *[[High anion gap metabolic acidosis]] | ||
|- | |- | ||
|[[pleural effusion]] | |[[pleural effusion]] | ||
| | | | ||
* [[Chest pain]], usually a sharp pain that is worse with cough or deep breaths | *[[Chest pain]], usually a sharp pain that is worse with cough or deep breaths | ||
* [[Cough]] | *[[Cough]] | ||
* [[Rapid breathing]] | *[[Rapid breathing]] | ||
* [[Shortness of breath]] | *[[Shortness of breath]] | ||
* [[Orthopnea]] | *[[Orthopnea]] | ||
| | | | ||
* Asymmetric chest expansion | *Asymmetric chest expansion | ||
* Diminished [[fremitus]], dullness on [[percussion]] | *Diminished [[fremitus]], dullness on [[percussion]] | ||
* Decreased or absent [[breath sounds]] | *Decreased or absent [[breath sounds]] | ||
* Reduced vocal resonance | *Reduced vocal resonance | ||
| | | | ||
* Appearance of fluid: milky, bloody, or clear | *Appearance of fluid: milky, bloody, or clear | ||
* Culture | *Culture | ||
* Cytology | *Cytology | ||
* [[Antinuclear antibody]] ([[ANA]]) >1 (systemic lupus erythematosus) | *[[Antinuclear antibody]] ([[ANA]]) >1 (systemic lupus erythematosus) | ||
* [[Amylase]] and severe [[acidosis]] ([[esophageal rupture]]) | *[[Amylase]] and severe [[acidosis]] ([[esophageal rupture]]) | ||
* [[Triglycerides]] (>110mg/dL = chylothorax) | *[[Triglycerides]] (>110mg/dL = chylothorax) | ||
* [[Hematocrit]] (pleural fluid to blood >0.5) | *[[Hematocrit]] (pleural fluid to blood >0.5) | ||
* [[Glucose]] 300 to 400 ([[peritoneal dialysis]]) | *[[Glucose]] 300 to 400 ([[peritoneal dialysis]]) | ||
|} | |} | ||
Revision as of 14:50, 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 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zarlakhta Zamani, M.B.B.S[zamanizarlashta@yahoo.com]
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][2]
| 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.
- ↑ Meyer TW, Hostetter TH (2007). "Uremia". N Engl J Med. 357 (13): 1316–25. doi:10.1056/NEJMra071313. PMID 17898101.