67 y/o male self presented to AH Hospital on 12/16/23 with c/o jaundice and renal failure. CT abdomen/pelvis + for cholelithiasis and 14mm pancreatic cyst. Pt admitted to LN Hospital on 12/18/23. Pt dx with renal failure, abdominal ascites, jaundice, inc. liver fxn, heart failure, pulm hypertension. Multiple specialists involved. (GI, Nephrology, Surgery, Pulmonology, Cardiology). Studies incl. MRCP which was inconclusive, renal US, unremarkable, Abdominal US-moderate ascites. CT abd/pelvis showed cholelithiasis and ascites. Despite studies, pancreatic and biliary system not adequately visualized. CA19-9 was 95.5. (led practitioners to include pancreatic cancer as DX). All specialists approved Pt d/c on 12/22/23 with instructions to f/u with hepatobiliary surgeon. Pt died on 12/31/23, days before his appt with surgeon. Family claims that healthcare providers were convinced pt had pancreatic cancer and had basically given up. Autopsy showed no cancer and attributed CA19-9 to pancreatitis. Cause of death was acute necrotizing pancreatitis with intraductal calcific debris. Expert should focus on diagnostic eval to determine etiology of multisystem failure.
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