Periampullary Carcinoma: Clinical Presentation and Diagnosis - a hospital based study

Abstract

This descriptive study was carried out including 10 patients with periampullary carcinoma in Nishtar Hospital, Multan. The objectives were to study different clinical presentations of periampullary carcinoma and various means of investigations to diagnose it. All patients having suspicion of periampullary carcinoma were studied. Original study included ten patients having remaining four patients were female. All male patients were smoker. Eight patients were amongst lower class, one patient was from middle class and remaining one patient was from upper class. Common clinical features were progressive painless jaundice, anorexia, weight loss, pruritis, abdominal pain, vomiting and malena. All patients were evaluated on history, clinical examination and laboratory investigations. All patients found to be anemic. LFT`s were raised in all patients. ERCP was successful in 90% of cases in diagnosing the pathology and biopsy was possible in 40% of cases. Ultrasonography was quite good in differentiating the type of jaundice. It detected the tumour site in only 20% of cases. Ultrasonography was not able to detect the metastasis effectively. CT scan was quite helpful to detect metastasis. Ultrasonography and ERCP were quite good in diagnosing the biliary obstruction. CT% scan was helpful in staging purpose. We do not have the facilities of endoscopic ultrasonography, MRI, MRCP, PTHC, helical tomography and laparoscopy.