Discussions By Condition: I cannot get a diagnosis.

please help me with a differential diagnosis

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: osucowboy
  • November 15, 2006
  • 04:23 AM

Hello, I am new and need help.

Here is the story. My uncle (57) is a runner, non-smoker, non-drinker who has lost about 25 pounds in the last two months. He has severe abdominal pain and decreased appetite. He is a M.D. and has access to good care. As of yet he has no diagnosis.

Tests:
CT x's 2 negative one spiral - chest and abdomen/pelvis
MRI negative
Endoscopic U/S Negative
Colonoscopy and flex sig Negative
EGD with Bx's Negative.
CBC wnl
ca19.9 - 11
swallowed the photo capsule and it was negative too!
liver enzymes wnl
Ca++ nl
Bilirubin nl no jaundice

Symptoms;
abdominal pain mainly left btwn xyphoid and umbilicus
early satiety
truncal rash - transient
feels better when laying straight out not fetal or sitting
borborygmi (constantly)
no diarrhea
no bloody stool
no hematuria/frequency/dysuria

He travels internationally frequently and has been in India and Khazakstan (sp?)in the last 6 mos. India in Sept, after he thinks the symptoms started.

As you can tell he has had a great pancreatic ca workup as well as any GI ca or liver. His weight has stabilized but he is now using ensure supplements, etc.

I suggested an accidental poisoning of some kind and he is pursuing that. He is also considering a diagnostic laparoscopy. Doesn't want the belly to stand in the way of a diagnosis! Has never had mental issues, but is willing to exhaust any possibilities. Now he of course is depressed about what seems to be life shortening sxs but no diagnosis. He has said if I were the doctor on the other side he would say you do not have cancer, but his gut tells him something is surely wrong.

Anyway, any suggestion would be wonderful!

Thanks so much.

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2 Replies:

  • just bumping up to the top again.
    osucowboy 1 Replies
    • November 15, 2006
    • 11:31 AM
    • 0
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  • Tell your uncle if he has lost 25 lb in a couple of months, he shouldn't need his gut to tell him something is or was wrong! My initial reaction to this is that it is probably a parasite of sorts. These are common in both Kazakhstan and India. If it originated from there though, it might be something a little out of the ordinary.
    Anonymous 42789 Replies
    • November 15, 2006
    • 01:56 PM
    • 0
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