4. It has no clear relationship to eating and
no radiation.
Her appetite is normal, she has no nausea
or vomiting and she has not lost weight.
Her bowl habit is normal and unchanged.
5. There is no relevant past or family medical
history.
She has never smoked, and drinks alcohol
very rarely.
She has worked all her life as an infant
school teacher.
10. An H2 antagonist was prescribed and
follow-up advised if her symptoms did not
resolve.
There was slight relief at first, but after 1
month the pain became more frequent and
severe, and the patient noticed that it was
relieved by sitting forward. It had also
begun to radiate through to the back.
11. Despite the progressive symptoms she
and her husband went on a 2-week
holiday to Scandinavia which had been
booked long before.
12. During the second week her husband
remarked that her eyes had become
slightly yellow, and a few days later she
noticed that her urine had become dark
and her stools pale.
On return from holiday she was referred to
a gastroenterologist.
13. She was found to have yellow sclerae with
a slight yellow tinge to the skin.
There was no lymphadenopathy and her
back was normal. As before her heart,
chest, and abdomen were normal.
17. Carsinoma of the pancreas can present
with non-specific symptoms in its early
stages.
It is an important cause of obstructive
jaundice.
Patients who have had a partial removal of
the pancreas are at risk of diabetes.
