Comments on: In which I reveal what caused the pancreatitis http://www.medrants.com/archives/4781 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Michael Kirsch, M.D. http://www.medrants.com/archives/4781/comment-page-1#comment-529100 Michael Kirsch, M.D. Wed, 19 Aug 2009 10:38:44 +0000 http://www.medrants.com/?p=4781#comment-529100 I could have used your astute student this yr. Saw pt with recurrent pancreatits. Cause remained a mystery to me. Ultimately, disovered she was an alcoholic. She had denied any abuse and held a responsible job. Was it my fault that I missed it? Could be. She fooled me and I'll be more suspicious next time. I could have used your astute student this yr. Saw pt with recurrent pancreatits. Cause remained a mystery to me. Ultimately, disovered she was an alcoholic. She had denied any abuse and held a responsible job. Was it my fault that I missed it? Could be. She fooled me and I’ll be more suspicious next time.

]]> By: david http://www.medrants.com/archives/4781/comment-page-1#comment-529096 david Wed, 19 Aug 2009 02:37:39 +0000 http://www.medrants.com/?p=4781#comment-529096 DB, Thanks. I agree with you. There is no requirement for cholecystitis in diagnosing gallstone pancreatitis. The gallbladder itself could have been pristine. It is the gallbladder bile, the source of the microlithiasis, that is the culprit. If you think about it, the finding of cholecystitis on MRCP did nothing to increase the odds that the gallbladder was the source of the pancreatitis. DB,
Thanks. I agree with you. There is no requirement for cholecystitis in diagnosing gallstone pancreatitis. The gallbladder itself could have been pristine. It is the gallbladder bile, the source of the microlithiasis, that is the culprit.

If you think about it, the finding of cholecystitis on MRCP did nothing to increase the odds that the gallbladder was the source of the pancreatitis.

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