What are the symptoms of late-stage ampullary cancer? Here are six points

What are the late-stage symptoms of ampullary cancer? Late-stage ampullary cancer can easily lead to obstruction of the bile duct and pancreatic duct. Its symptoms mainly include: bile duct obstruction, manifested as jaundice, itchy skin, darker urine color, lighter stool color, bile duct and pancreatic duct obstruction causing indigestion leading to weight loss, and tumor invasion of visceral nerves leading to serious problems.

There are almost no symptoms in the early stages of ampullary cancer. Once symptoms appear, they are usually in the late stage. The main symptoms in the late stage include nausea, vomiting, painless jaundice, and black stools. A few cases will present with acute pancreatitis.

The main late-stage symptoms of ampullary cancer are jaundice and pain, but obvious jaundice, skin itching, ascites, weight loss, weakness, etc.

(I) Abdominal pain and discomfort: 40-70% of pancreatic cancer patients experience abdominal pain as the first symptom, while 30% of ampullary cancer patients also experience this phenomenon. The causes of abdominal pain include:

① Strong contraction caused by obstruction of the bile and pancreatic duct outlet, the abdominal pain is paroxysmal and located in the upper abdomen, such as biliary colic.

② Visceral neuralgia caused by increased pressure in the bile duct and pancreatic duct manifests as dull pain in the upper abdomen, which worsens 1 to 2 hours after a meal and eases after a few hours.

③ The pain in the waist and back caused by cancer infiltration and compression of the celiac plexus is severe. Patients often sit or lie on their sides with their backs hunched all night. This is mostly a late-stage symptom.

(ii) Jaundice: Painless jaundice is the most prominent symptom of pancreatic head cancer, accounting for about 30%. Because pancreatic uncinate cancer is far away from the ampulla, only 15-20% of patients experience jaundice. In the late stage of pancreatic body and tail cancer, jaundice may also occur due to metastasis and compression of the common bile duct or portal lymph nodes. Jaundice is persistent and progressively deepens. Almost all patients with ampulla cancer have jaundice. In some patients, jaundice may fluctuate significantly due to ulceration and shedding of the tumor.

(III) Weight loss: Fatigue is caused by decreased food intake, indigestion and consumption by cancer.

(IV) Gastrointestinal symptoms: Most patients have loss of appetite, aversion to greasy food, nausea, vomiting, indigestion and other symptoms. 10% of patients with ampullary cancer have a history of gastrointestinal bleeding and tarry stools due to ulceration of the tumor.

(V) Fever: Pancreatic cancer with fever is rare, but patients with ampullary cancer often have a history of fever and chills, which is caused by secondary infection of the bile duct.

(VI) Physical signs: often accompanied by liver enlargement. According to Courvoisier's rule, painless jaundice accompanied by gallbladder enlargement is a characteristic of pancreatic head cancer. It has reference value in differentiating it from cholelithiasis, but it is not necessarily reliable because cholelithiasis is often accompanied by secondary infection.