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Adam Knowles

The document discusses a 68-year-old man presenting with signs of pancreatic malignancy including reflux, back pain, diarrhea, abdominal pain aggravated by food, fatigue, weight loss and jaundice. Initial tests showed elevated bilirubin, amylase, ALT, and alkaline phosphatase with low albumin. The patient has a history of gallbladder removal and depression.

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330 views2 pages

Adam Knowles

The document discusses a 68-year-old man presenting with signs of pancreatic malignancy including reflux, back pain, diarrhea, abdominal pain aggravated by food, fatigue, weight loss and jaundice. Initial tests showed elevated bilirubin, amylase, ALT, and alkaline phosphatase with low albumin. The patient has a history of gallbladder removal and depression.

Uploaded by

ioannak
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Dr Dev Desai

Gastroenterologist
City Hospital
Easton

30/8/2019

Dear Dr Desai,
Re: Mr Adam Knowies, D.O.B: 22/8/1951

Thank you for seeing Mr Adam, a 68-year-old retied management consultant, who
is presenting with signs and symptoms indicative of pancreatic malignancy. His
condition requires your urgent management and the assessment for an
endoscopy.
On today’s visit, Mr Adam’s reflux symptoms had not improved, although TAKING
the medication he was given. He stated HAVING back pain, diarrhea, pale stools.
He had had, also, abdominal pain AGGRAVATED aggravating by food and fatigue.
He had lost 2 kg from the previous visit. On examination, he had yellow
discoloration of his skin and eyes. His TEST tests results showed the following: the
bilirubin was 9 mg/dl, the amylase was 400u/l, the ALT was 60u/l, the Albumin
was 6g/dl and the Alkaline phosphatase was 120u/L. The patient was informed
about the examination and blood results findings and the possibility of having
pancreatic malignancy.
On initial visit, on 2/8/2019, Mr Adam had been suffering from heartburn
sensation and indigestion. He had taken over-the-counter antacids with no
improvement of his symptoms. His weight was 92 kg. On examination, nothing
abnormal was detected. He was given PPI 20mg 2 tablets a day, for 8 weeks. FBC
and liver function test were ordered. It was suggested he return in 4 weeks.
As far as his medical history is concerned, Mr Adam in 2008 had his gallbladder
removed, due to gallstones. He has a history of depression FOR the past 4 years
and he has BEEN TAKING taken fluexitine, since 2016. As for his social history, he is
married with 2 children. He is active and he is a social drinker.
Thank you for your ongoing care of Mr Adam. Should you have any questions, do
not hesitate to contact me.
Yours sincerely,
Doctor

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