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Anyone have any ideas of what could be going on?
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Anyone have any ideas of what could be going on?

In Nov of 2011, I went to ER complaining of blood in stools,but
completely asymptomatic. I did not experience any nausea, pain, or
diarrhea. Blood test lipase levels were at 1700 (ref 73-393), I was
then admitted me to hospital. Abdominal Ultrasound, CT scan with and
without contrast were normal. Day 2 lipase went to 1055 (ref 73-393).
I was finally released since on day 3. My discharge papers said Acute
Pancreatitis. Not sure if I have an issue with high lipase or
pancreatitis.

Since then I tested to see if I had celiac disease, h ploryi, ulcers
and all came back normal. CBC test are normal along with diabetes and
metabolic panels.

Lipase
11-17-11
1700 (ref 73-393)
11-18-11
1055 (ref 73-393)
5-25-12
38 (0-58 u/l)
2-21-13
25 (0-58 u/l)
3-28-13
58 (0-58 u/l)
4-1-12
62 (0-58 u/l) HIGH

Possibilities
-Truly an isolated incident
-Early onset of CP from HP. However I have no family members in any
generation with pancreatitis. However usually HP presents itself at an
early age around 10-20 with eveidence on scans most of the time.
-Small biliary sludge not seen in scans
-Acute pancreatitis from 3 beers. I only drink a few times a year.
Gastro thought I was covering something up.

More possibilities below:

Idiopathic pancreatitis under age 40
Quote:
Extensive or invasive evaluation is usually not recommended in those
with a single episode of pancreatitis who are younger than 40 but some
reports recommend endoscopic ultrasound (EUS) even after one attack if
the cause is not clear to look for pancreatic ductal abnormalities,
small tumors at or near the ampulla, microlithiasis in the gallbladder
or bile duct, and early chronic pancreatitis. Undiagnosed early
chronic pancreatitis may, in fact, be a very common cause of
"idiopathic recurrent acute pancreatitis". Endoscopic retrograde
cholangiopancreatography (ERCP) should not be performed after a single
episode of acute pancreatitis in the absence of laboratory or imaging
evidence of choledocholithiasis. http://www.uptodate.com/


Idiopathic pancreatitis
Quote:
BACKGROUND In about 20 to 40 percent of cases of acute pancreatitis,
no cause can be found, and these are labeled idiopathic. In this
study, we sought to determine the frequency with which patients with
acute idiopathic pancreatitis have biliary sludge, a suspension of
cholesterol monohydrate crystals or calcium bilirubinate granules that
is found predominantly in the gallbladder. METHODS Between 1980 and
1988, we prospectively studied 86 patients who had acute pancreatitis.
In patients with no known cause of pancreatitis and no
ultrasonographic evidence of gallstones or dilatation of the biliary
ducts, we determined how often biliary sludge was present and its
subsequent fate by repeated microscopical examinations of bile samples
and abdominal ultrasonography.http://www.ncbi.nlm.nih.gov/pubmed/9193774


Anyone have any ideas of what could be going on? My gastro and primary
doc refuses to send me for EUS or any other test.
4 Comments Post a Comment
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Avatar_m_tn
I forgot to mention I did have an older aunt AGE 55 who suffered acute
pancreatitis with extremly horrible pain, however she is an extremely
heavy drinker for over 40 years. She also suffered a stroke due to her
alcholism (alcoholism). She literally wakes up in the morning to have a beer. Me I
drink only a few times a year. My neighbor is a young man in his early
20's and he drinks heavily as well, he is also had horrible pain.

Does my aunt have HP due to her drinking still put me in the category
of having HP.

I am not looking for a diagnosis on the INTERNET, I understand that
you're not doctors. Just need a better understanding from others
experience with the disease.

Just curious, I had no symtoms (symptoms) even at time of diagnosis, everything
happend by accident. The blood from stool was determined to be
hemorrhoids and was treated.

According to WIKI
"Families are defined as having HP,[5] if the phenotype is consistent
with highly penetrant autosomal dominant inheritance. In simple terms,
this would require two or more first degree relatives (or three or
more second degree relatives) to have unexplained recurrent-acute or
chronic pancreatitis in two or more generations. It is an autosomal
dominant disease with penetrance that is generally accepted to be
≈80%.[1][8]"http://gut.bmj.com/content/45/3/317.long
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1711789_tn?1361311607
Hi there!

Well, without knowing the relevant clinical details or a detailed clinical evaluation it would be difficult to comment specifically on the situation. Since this has been a single episode without any apparent symptoms and there has been no abnormalities detected with primary investigations, this is likely to be a mild idiopathic case. Also since there are no risk factors present, further investigations may not be suggested unless there is a specific indication or a repeat episode/ recurrence. I would suggest discussing the situation in detail with your treating gastroenterologist.
Hope this is helpful.

Take care!
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Avatar_m_tn
Hi, buddy I don't want to scare you but I've got almost the samething twice last year. After having seen my gastroenterologist , she did a gastroscopy and she has seen variscose in my esophagus so she fixed that  by putting medical elastic band to heal them. Since then I have  medication to take for my stomach, and another one to lower my blood pressure.
Good luck!
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Avatar_f_tn
Hi, I have found this thread quite late and I hope you have found an answer and not suffered any further painful episodes.  I just wanted to say that I too, presented at emergency with severe pain just over 3 years ago.  It was discovered that my pancreas is severely calcified.  I do not drink or smoke and did not present with gall-stones.  I was referred to a brilliant endocrine surgeon and It was discovered my pancreatitis was caused by an overactive para-thyroid gland.  This has now been removed and I have not suffered another attack since.  Hope all is well and this helps,
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