Need help interpreting scan results

Digestive health
1

Hi all, I was wondering if any of you could help interpret my scan results? I got a copy of them from my family doctor, and his and my GI doctor's impression of them was that all of my tests were normal.

My scan results are as follows:

Ultrasound (August 3, 2016): "The pancreas is generally hypoechoic diffusely, but otherwise unremarkable, except for a cystic lesion in the tail of the pancreas. This cyst is 12mm. in diameter, with clear fluid contents and sharp peripheral definition. This appearance is most consistent with a poorly active cystic lesion, like a cystadenoma rather than a pseudocyst, but further correlation with follow up in 2-3 months would be of value as well as clincal findings. No significant abnormality is seen in the ultrasound of the abdomen. However, clinically possibility of pancreatitis should be excluded."

CT scan (August 7): The liver, gallbladder, spleen, pancreas, adrenals and kidneys are normal. The small and large bowel are not dilated. There is fecalization of the terminal ileum with fatty appearing stools. There is no upstream obstruction and no focal inflammatory change is present. There is no free fluid and no free air. No acute or destructive osseous lesion is seen."

Ultrasound (Nov. 12): The previous cyst noted in the tail of the pancreas is no longer visible. The pancreas appears now to remain slightly hypoechoic but normal in size and morphology otherwise. Possibility of previous pancreatitis is suggested. The gall bladder, common hepatic duct, hepatic size and parenchymal pattern major abdominal vessels, spleen, and both kidneys appear unremarkable. No other significant abnormality is seen.

MRI (Nov. 30): There are no appreciable hepatic or splenic abnormalities. The gallbladder is unremarkable and there is no evidence of biliary dilation. No focal pancreatic abnormalities are visualized and the pancreatic duct is not dilated....No significant abnormalities identified without the abdomen. Specifically, the pancreas is grossly unremarkable."

I've read online that "hypoechoic" refers to the pancreas looking darker than surrounding tissue. Is this normal or could it be an indication of what is wrong with me? It's frustrating to have constant upper abdominal pain with no real answers. I have another appointment with my GI doctor on Wednesday to hopefully book an endoscopic ultrasound.

I also had an upper endoscopy done (Sept. 1), which was negative for inflammation and ulcers.

Any help is much appreciated!

2

Hi jon, I don't know what your symptoms are currently or what led you to the doctors in the first place so I'm just going on what you've posted ok.

It seems reasonable to me that you may have had symptoms relating to the lesion which have since settled down.  I don't think the doctors are making light of it or fobbing you off, messing about with the pancreas isn't a choice most would make without jolly good reason and all your tests idicate everything is normal.

It's entirely possible it was a one off, the lesion's gone and it's quite possible you had an attack of acute pancreatitis because of that.  It's also possible you'll never have a repeat, especially if you follow the no alcohol, low fat diet regime, for awhile at least.  Actually a low fat diet is probably a good life choice regardless.  Stressing makes everything worse so focus on the fact that there is absolutely nothing wrong according to the tests at this point. 

However, just so you know, the pancreas takes forever to heal so your ongoing issues might be because of that.  Checking your diet might be an idea too, you might be eating something you can't tolerate.

I'd certainly ensure there's a follow up programme so no nasty surprises pop up but there's nothing you can do, nothing you want to do re messing about with the pancreas just to have a closer look for instance, the pancreas doesn't tolerate invasive procedures. 

I think you received a nasty shock and perhaps read some scary stuff.  Take a deep breath and thank your lucky stars all's well at this point.  Perhaps you've been enlightened about the importance of healthy lifestyle choices. See the positives.   I don't know if this has helped ease your mind, it's difficult based on one post. 

 

3

My GI has a terrific PA who has been helpful in interpreting results.  (Her office was the one that set up my recent MRI).  After reading them, my husband and I thought we understood what they were saying, and assumed they concluded chronic pancreatitis.  However in talking with the PA, she said it was one possibility, but a lot of other results suggested it was NOT and there might be another reason, so I'll have an endoscopic sonogram in a couple days to learn more.  In other words, I don't think any of us who have or are going through a similar experience, can't comment or provide you with useful "interpretations" of your results.  

Make a list of the questions you have, and ask.  Can you email your GI?  I just did that to the PA who works with mine, and she is easy to talk with and called back about 5 minutes after I sent her an email with my list of questions.  Besides, it helps for you to get your questions down "on paper" in front of your eyes.   

4

Hi Reefsider, thanks for the reply.

My pain has pretty much been constant since June, so although my scans all look good the symptoms are unfortunately still there. My biggest fear is that I now have chronic pancreatitis, and that my condition will not improve. Still hoping though that someday this pain and suffering will end.

5

Hi Diane, thanks for your advice. I'm actually seeing my GI doctor tomorrow so I have a list of questions prepared (one of them being the same as what's in the OP). I'll ask about an e-mail address, unfortuantely right now I have no way of contacting her without seeing her in person.