Sunday, October 21, 2012

Pancreatitis: Why Doesn't My Pancreas Damage Show on EUS or CT?

pancreatitis - minimal change chronic pancreatitis
Many people have asked me why they have had recurrent attacks of acute pancreatitis or have had one doctor diagnose them with chronic pancreatitis only to have another say they don't have chronic pancreatitis or any pancreatitis at all.

For those of you who have had this kind of experience with your pancreatitis journey let me assure you that not all doctors know what they are taking about when it comes to acute or chronic pancreatitis. Even those who have some knowledge don't know everything even if they think they do. In fact ...

They have "cookie cutter" diagnostic criteria and for those who even know ANYTHING about the disease and can even recognize it in a clinical setting miss it or rule it out when you don't fit that "cookie cutter" mold.

Diagnostic criteria and scoring for acute pancreatitis
Diagnostic criteria for chronic pancreatitis

IF someone doesn't fit the "cookie cutter" mold the disease is most often ruled out. But ...

Dr. Sutherland says different in regards to chronic pancreatitis and he has a list of certfications and is kudosed as being one of the top authorities. He is:
  • Director of the Diabetes Institute for Immunology and Transplantation
  • Head of the Transplant Division in the Department of Surgery
  • Holder of the Golf Classic "fore" Diabetes Research Chair
  • Professor of Surgery at the University of Minnesota
I found this on Dr. Sutherland's blog/forum: "There are articles on minimal change CP that I will send you the references. We also have an abstract showing that the traditional view that an EUS has to show 5 of 9 criteria for CP to be diagnosed is not correct, even one criteria has been associated with documented CP under the microscope." Read the article here

Now keep in mind he makes a boatload of money from pancreas surgery and is regarded as one of the best when it comes to TP/AIT so there is always the possibilty he is pushing for more surgeries but my gut feeling and common sense tells me that he is correct about minimal change chronic pancreatitis.

This means that whether or not your damage presents on radiological testing in blazing colors you still most likely have chronic pancreatitis, it isn't all in your head, your symptoms are real and you need to get a handle on your condition and control it or you may be faced with becoming one of the "gutted" survivors.

Minimal Change Chronic Pancreatitis (scholar type articles):

1: article one
2: Pdf article two
3: article three
4: Pdf article four

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