Test results and continuing pain

[Joe Joe D.]

Hi Doctor: I went to the gastroenterologist with stomach pain. I had endoscope which showed nothing.Then i had abd. ultrasound and it found enlarged liver + spleen and a suspicion of a 1.5x1.1x1cm hypoechoic structure on head + neck of pancreas.I was scared to death.I then went for a ct scan which showed normal size liver+ pancreas with no masses on either one.However the only abnormality on scan was enlarged spleen 16cm.I still get pain in upper left abdomen which goes across rib cage and into upper left shoulder blade. Could this pain be from the enlarged spleen?  The woman who did ultrasound was having difficulty reading the test because she said i was very gassy.The doctor came in to read the test live so i asked if there was a problem they told me sometimes the pictures don't come out right and they need to see it in real time.I also have had low platelets for the last 17yrs (Itp).Could this account for spleen enlargement.The pancreas still worries me.Should I take comfort in the fact that it was normal size.Also had Liver and Lipid screen test which were normal.Only triglycerides were high 331.

[Kevin Pho, MD]

Yes, ITP is a cause fo spleen enlargement.  Certainly if the spleen is enlarged enough, it can cause the abdominal pain you are describing.  

Other tests to evaluate for possible pancreatic cancer would be an ERCP, MRI or endoscopic ultrasound.  If this diagnosis is still considered, then you may want to consider these more specialized tests.

If those tests are negative, and the spleen has been excluded as a cause, you can consider tests to evaluate the gallbladder function - which can atypically present with pain on the left side.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.