can appendicitis be misdiagnosed as early chronic pancreatitis

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The reason I ask is over the past year my husband has had blood tests showing normal. Upper endoscopy and lower colostomy endoscopy which showed a duodenal ulcer. Now cleared. He had a ct scan and mri which showed a pseudo cyst in the head of his pancreas. He then had an ultrasound endoscopy which showed no pancreatic cancer and they drained the cyst. On the letter they put acute or earlchronic pancreatitis ???? as they weren't 100% sure. He saw the gastroloist in December who said chronic pancreatitis. No medication has been given and they have never mentioned lipase levels like I've seen in other posts. He's had vomiting, loose stools, constipation over time at varing levels. Over this weekend he had severe pain. He went to A & E and has been admitted with appendicitis. Confirmed by ct scan. A dr previously said a few months baxk that he thought my husband had grumbling appendix. Has anyone heard of this happening and been wrongly diagnosed with chronic pancreatitis for it to be appendicitis or is that wishful thinking on my part. X

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  • Posted

    Yes, I have heard of this however, an EUS (Endoscopic Ultrasound) IS the most sensitive test for Chronic Pancreatitis. There are 9 criteria that experienced endoscopists look for called the Rosemont Criteria. If he had an EUS, what number of criteria were found would indicate whether he has CP.
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    • Posted

      As far as I'm aware nothing significant. In fact they put chronic pancretitis and several question marks. What would I specifically expect to see in the points you mentioned? To be fair they tell you very little. He had a routine mri in may and has had to chase his appointment which isn't until Sept. He is still having pain and a bout if vomiting . Thanks for the reply.

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  • Posted

    Send me a copy of the EUS report
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    • Posted

      Hi Greg. Sorry about the delay in my reply. Here us the report that was dine at The Royal Marsden Endoscopy Suite Chelsea in Nov 2014

      Procedure: EUS

      Findings:

      Oesophagus: normal

      Stomach: normal

      Pylorus: normal

      Duodenum: normal

       

      There was cystic dilatation (11mm x 5.7mm) of the main pancreatic duct in the head of the pancreas, and normal diameter in the rest of the pancreas, the duct being normal upstream.  The pancreatic tissue was inhomogeneous with stranding and hypoechogenicity, but did not fulfill the criteria for chronic pancreatitis

       

      ,

      FNA not performed

      As you can see doesn't really confirm as definite. We saw the consultant 22.12.15 and he said it was chronic pancreatitis and not anything else. Since then my husband had appendicitis and had it removed. He has had another mri in may just before the appendicitis and now has the follow up appt with the gastrologist in sept. Any thoughts. Best regards Theresaa

       

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    • Posted

      Conclusions: recent acute, ? early chronic pancreatitis.  Suggest review imaging and consider ERCP

      Sorry the last part of the report got cut off which was the conclusion

      regards Theresaa

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  • Posted

    There is no correlation between appendicitis and chronic pancreatitis. If he has had an Endoscopic Ultrasound this test is very specific for looking for abnormalities in the pancreas for chronic pancreatitis. The Rosemont criteria has 9 indications for CP. If > 5 are found the disease is essentially confirmed.
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    • Posted

      Hi. I know it's been over a year but I just need to ask a question. My husband still has pain and vomiting and has been told he has a fatty liver and this can cause these symptoms. Today he has had a endoscopy and colonoscopy. They say the are normal and uneventful. Biopsies have been taken as standard and they are screening him to see if he is ceaolic. I'm totally confused now as to what his has. Is it definitely CP which is what they are treating him for. All blood tests and kidney function are fine and nothing outstanding there to show. No weight loss and no medication precribed apart from omeprazol. Any ideas??

      Thanks

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