A 46-year-old patient with a very severe alcohol consumption of more than 150 g/day and a smoker of 1.5 packs/day was admitted to the emergency room after being found in public convulsions.
The patient had a history of two acute pancreatitis in four and three years prior to admission, and a last admission due to alcoholic acute pancreatitis in another center 18 months prior to admission to our center with a first CT scan in which a 9 mm cyst was found.
On arrival to the emergency department she had glasgow 15/15 with peripheral tremor and diaphoresis. She reported having decreased alcohol consumption in the last days due to increased abdominal pain.
He did not report vomiting.
Laboratory tests showed hb 13 g/dL, hto 40%, leukocytes 8,500.
74 IU/ dL
A magnetic cholangiopancreatography showed focal pancreatitis of the pancreatic-duodenal sulcus with a thickened duodenal wall pseudocyst and thickened duodenal wall without producing stenosis, compatible with cystic duodenal dystrophy and endoscopic ultrasound finding of spots
Since the patient is asymptomatic for dystrophy medical treatment with octreotide is initiated.
At the same time, alcohol detoxification was achieved by reducing the doses of benzodiazepines to 15 mg of diazepam a day and starting an interdictor.
Abdominal CT showed a solid renal lesion of two centimeters in the lower right renal pole compatible with hypernephroma, so the patient began outpatient study by the urology department.
