In a recent Grand Rounds presentation, Stuart Spechler, MD, Co-Director of the Center of Esophageal Diseases at Baylor University Medical Center and Co-Director of the Center for Esophageal Research at Baylor Scott and White Research Institute, presented new findings for patients with PPI-refractory heartburn.
Pancreatic adenocarcinoma (PDAC), the most common type of pancreatic cancer, is the fourth leading cause of cancer-related death in the United States. It is an extremely slow growing tumor. PDAC normally remains undetectable until late in the disease process, due in part to the physical location of the pancreas. It is situated behind the stomach at the back of the retroperitoneal space, overlaying the aorta, vena cava, and spine, deep inside the body. Because of the location of the pancreas, a computed tomography or magnetic resonance imaging scan is typically needed to detect a lesion, so it may not be discovered until the patient develop symptoms. PDACs located in the head of the pancreas may obstruct the bile duct, resulting in jaundice. Approximately 80 percent of PDAC cases present with this painless jaundice. When the lesion is located in the body or tail of the pancreas, however, the first symptom is likely to be pain associated with invasion of the spleen or stomach, occurring much later in the course of the disease.
