29. Klinik und internistische Diagnostik des Pankreas-Carcinoms

Abstract

The patients seen at the medical clinic of a community hospital over 6 years included 291 with diseases of the pancreas, 52 of whom had carcinoma of the pancreas. Their signs and symptoms are listed. The triad of weight loss, icterus, and abdominal pain was the commonest symptom cluster. In one third of the cases the serum lipase was raised though the blood level of amylase was normal. Laparoscopy led to exploratory laparotomy in 94 percent of cases, which was performed an average of 14 days later. The future will show whether ERCP (+cytology) and CEA will improve the possibility of early diagnosis.

Carcinoma of the pancreas

“…Other rather non-specific clinical findings in carcinoma of the pancreas are, in descending order of frequency, epigastric bloating and flatulence, weakness and/or fatigue, diarrhoea, vomiting and constipation (Gambill, 1970). Much less common clinical features are gastro-intestinal bleeding due to invasion of duodenum or stomach, and steatorrhoea or " pancreatic sprue " due to failure of pancreatic enzymes to reach the small intestine; both these features are usually late manifestations, sprue occurring in only about 10 per cent of patients (Gambill, 1970;Schirmeister and Kauth, 1975;Brooks and Culebras, 1976). The occurrence of chronic pancreatitis and diabetes mellitus in patients with carcinoma of the pancreas has already been discussed.…”