DOI: 10.12890/2021_002207
Missed Diagnosis of Cholangiocarcinoma Presenting with Atypical Symptoms
Authors
yuki.gym23@gmail.com
Keywords
Cholangiocarcinoma, visceral pain, referred painAbstract
We report a case of delayed diagnosis of cholangiocarcinoma. A 62-year-old man developed acute abdominal pain in multiple sites. As the distribution pattern of the abdominal pain was not correctly interpreted based on the mechanisms of visceral and referred pain, the patient was not investigated with the best diagnostic test at first presentation.
Moreover, miscommunication between physicians in a clinic and separate hospital delayed diagnosis. For prompt diagnosis, physicians should be practice careful reasoning and focus on good communication with physicians outside their hospital.
References
- Khan AS, Dageforde LA. Cholangiocarcinoma. Surg Clin North Am 2019;99:315–335.
- Doran FS. The sites to which pain is referred from the common bile-duct in man and its implication for the theory of referred pain. Br J Surg 1967;54:599–606.
- Drewes AM, Arendt-Nielsen L, Jensen JH, Hansen JB, Krarup HB, Tage-Jensen U. Experimental pain in the stomach: a model based on electrical stimulation guided by gastroscopy. Gut 1997;41:753–757.
- Gebhart GF, Bielefeldt K. Physiology of visceral pain. Compr Physiol 2016;6:1609–1633.
- Sikandar S, Dickenson AH. Visceral pain: the ins and outs, the ups and downs. Curr Opin Support Palliat Care 2012;6:17–26.