Detailed Treatment Process
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Female, 65 years old. Last summer, the patient began to experience recurrent abdominal pain. Ultrasound imaging report Ultrasound description: Kidneys: Both kidneys normal in size and shape, with clear outlines and homogeneous parenchymal echoes. No abnormal echoes in the collecting system. Several strong echo spots visible in both kidneys, measuring approximately 2 × 3 mm. Ureters: No dilatation on either side. Bladder: Well filled, with smooth wall and no obvious abnormalities in the lumen. Uterine myometrium shows homogeneous echoes, central endometrial line, with a strong echo mass inside measuring approximately 10 × 4 mm. No obvious abnormalities in the bilateral adnexa. CDFI shows no significant abnormal blood flow signals. Ultrasound impression: 1. Small calculi in both kidneys. 2. High-echo mass in the uterus (consider calcification; please correlate with clinical findings). Examination time: January 7, 10:04
Electronic gastroscopy report Date: January 6 Department: Outpatient Findings: Esophagus and cardia normal. Gastric fundus and body mucosa intact with normal color, no masses or ulcers seen. Gastric angle mucosa smooth. Patchy erythema in the antral mucosa. Pylorus round and well open. Duodenal bulb shows bile-stained spots; descending duodenum normal. Diagnostic impression: Superficial gastritis with bile reflux (Post-treatment follow-up) Time: January 6, 05:04:32
Colonoscopy and treatment report Department: Endoscopy Findings: Colonoscopy advanced to the cecum. Mucosa of the ascending colon, transverse colon, descending colon, sigmoid colon, and rectum showed no congestion or edema, and no masses or polyps were seen. Repeated examination four times at 40 cm from the anus revealed no abnormalities. Digital rectal examination: normal. Diagnosis: Colonoscopy normal. Examination time: February 2
Radiology report (CT) Department: Internal Medicine Emergency Class III Clinical diagnosis: Abdominal pain Request: Assist in diagnosis Examination time: February 10, 12:12:14 Report written: February 10, 12:51:03 Report verified: February 10, 12:57:28 Examination: Abdomen Method: Plain scan of abdomen and pelvis Radiological findings: Enlarged pancreatic head with heterogeneous density and multiple enlarged surrounding lymph nodes. No thickening of the anterior renal fascia. Liver surface smooth, lobes in normal proportion; patchy low-density shadow in the right lobe of the liver (im18), with ill-defined borders. Spleen not enlarged, homogeneous density. No dilatation of the bile ducts. Pancreas and both kidneys appear normal. Slightly enlarged lymph nodes in the pelvis. No fluid in the abdominopelvic cavity. Radiological diagnosis: Space-occupying lesion in the pancreatic head with surrounding enlarged lymph nodes and low-density focus in the right lobe of the liver. Enhanced CT or MRI recommended. Enlarged uterus with calcification; please correlate with ultrasound.
At this point, the family contacted this service. This service advised immediate emergency evaluation and to specifically request abdominal CT from the doctors. Abdominal CT revealed a space-occupying lesion in the pancreas with peripancreatic infiltration, enlarged surrounding lymph nodes, and multiple intrahepatic metastases, consistent with advanced pancreatic cancer. The patient passed away several months later.