ROSH Gastrointestinal Practice Exam

What diagnosis should be considered for a patient presenting with chronic abdominal discomfort and a confirmed evaluation of gastritis?

1. Pyloric stenosis

2. Pancreatic cancer

3. Cholecystitis

4. Hepatitis

The correct answer is: Pancreatic cancer

In the context of a patient presenting with chronic abdominal discomfort alongside a confirmed diagnosis of gastritis, one should consider pancreatic cancer as a potential diagnosis. Pancreatic cancer can manifest with nonspecific abdominal symptoms, including chronic discomfort. The location of the pancreas in relation to the stomach and duodenum means that inflammation or obstruction, such as that caused by a tumor, can lead to symptoms that may initially be attributed to gastritis. Additionally, chronic gastritis can sometimes mask or overlap with symptoms of pancreatic issues, making it a challenging clinical picture. When evaluating a patient with gastritis and chronic abdominal pain, it is prudent to consider serious underlying conditions like pancreatic cancer, especially in the context of risk factors such as age, smoking history, family history of pancreatic cancer, or symptoms like weight loss and jaundice. These additional indicators would further raise suspicion of an underlying malignancy rather than a purely gastrointestinal inflammatory process.