Xiu Zhang, a 58-year-old woman, visits an internal medicine practice. Her daughter, Meiling, brings her in, explaining that her mother has not had primary care physician since emigrating from China eight years ago.
Mrs. Zhang recently saw a gastroenterologist after having nausea and diffuse aching abdominal pain, at times severe, for six weeks. She had been working in a retail store but stopped because of her symptoms. Her medical history reveals sciatica-type pain six years ago, which resolved.
At her daughter's insistence, Mrs. Zhang underwent a series of diagnostic procedures ordered by the gastroenterologist. Upper and lower endoscopies were normal. A computed tomography (CT) of the abdomen showed a mass in the head of the pancreas. Biopsy of this mass via ultrasound-guided endoscopic retrograde cholangiopancreatography (ERCP) confirmed pancreatic adenocarcinoma. The gastroenterologist explained this diagnosis to Mrs. Zhang and her daughter.
© 2016 University of Washington | School of Nursing | L&IT Learning Technologies | Palliative Care Training Center | National Institute of Nursing Research (NINR) at the National Institutes of Health (NIH), 1R21NR010896-02A2.
