A 66-year-old man presents with a sudden onset of diabetes, anorexia, weight loss, epigastric pain with radiation to back. Next best investigation for this patient is?
Ans. B CT abdomenRef: Bailey and Love: 26th ed. page 1137* The clinical history of epigastric pain radiating to back points to pancreatic etiology. This patient may have developed pancreatic cancer. Sudden onset of diabetes in the elderly is also suggestive. The best imaging modality to image chronic pancreatitis or pancreatic malignancy is CT abdomen.* Choice A is ruled out as gas shadows of stomach obscure ultrasound view of pancreas.* Choice C is fluoroscopic intubation-infusion small- bowel examination which is used to evaluate for small bowel pathology while this patient has pancreatic lesion* Choice D is ruled out as it used for large bowel evaluation.
Ultrasound of abdomen
CT abdomen
Enteroclysis
Triple contrast barium enema
Misc.