Symptoms of periampullary cancer?

summary

Periampullary carcinoma (VPC) is the general term of carcinoma growing in ampulla of Vater, duodenal papilla, lower end of common bile duct, opening of pancreatic duct and medial wall of duodenum. The common feature is that the obstruction of common bile duct and main pancreatic duct can be caused when the cancer is small, so jaundice appears early. The age of onset was mostly 40-70 years old, mostly male. The main manifestations were jaundice, epigastric pain, fever, weight loss, hepatomegaly, gallbladder enlargement, etc. Now let's talk about the symptoms of periampullary cancer.

Symptoms of periampullary cancer?

Jaundice appears earlier, and abdominal pain appears at the same time or successively, progressive aggravation, belongs to obstructive jaundice, skin and mucosa yellow staining is obvious, can be dark green, more accompanied by skin itching. Jaundice is persistent in most patients. Jaundice subsides or alleviates in a few patients due to tumor necrosis and bile duct recanalization, but it deepens again later and presents fluctuating jaundice. Progressive aggravation of jaundice is the late manifestation. Attention should not be mistaken for cholelithiasis or hepatocellular jaundice.

Abdominal pain in the upper abdominal pain in 3 / 4 of the cases, and is often the first symptom. In the early stage, some patients (about 40%) may have increased intraluminal pressure due to expansion of common bile duct or obstruction of pancreatic juice discharge, resulting in blunt pain under xiphoid process. Abdominal pain may radiate to the back, and often aggravate after eating, evening, night or fat meal, but it is not as serious as pancreatic head cancer.

Intermittent chills and fever are often caused by tumor rupture, cholestasis and biliary tract infection. It is characterized by repeated sudden arrest, transient hyperthermia with chills, leukocytosis, and even toxic shock. Clinically, it is easy to be misdiagnosed as cholangitis and cholelithiasis, and the treatment with antibiotics and hormones is ineffective.

matters needing attention

Of course, we need to do a good job of individual assessment before accepting the operation of periampullary cancer. This is because once we can't do a good job of disease assessment and blindly operate, then we can't guarantee the smooth progress of the operation. Therefore, we need to consider more knowledge of periampullary cancer from multiple perspectives.