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What Causes A Lump At The Bottom Of The Sternum While Having Pancreatitis?

Posted on Fri, 11 Nov 2016

Question: Hi. So earlier this year I was diagnosed with pancreatitis from excessive drinking and antibiotics, and the first time it happened I noticed my xiphoid process was protruding, which it never did before. I thought it was just swollen from the way I was laying or something but it's been that way for a year now, and sometimes feels sensitive. I told the doctor about it when I was in the hospital, he didn't seem to think it was relevant, but now I'm wondering if maybe it's because my pancreas is swollen? Or something? I don't know what could have caused it.

Answered by Dr. Dr. Happykumar Kagathara (14 hours later)

Brief Answer:
Xiphoid swelling is not associated with chronic pancreatitis

Detailed Answer:
Hello,
1) You might have alcohol related chronic pancreatitis and you might require hospitalization for acute episode of this chronic pancreatitis.
2) Xiphoid process swelling is not related to pancreatitis.
3) But if duration of chronic pancreatitis is long or you have repeatedly acute episode of chronic pancreatitis then pancreatic pseudocyst (collection of fluid with surrounding wall formation in region of pancreas) might develop. Size of such cyst range from 2cm to 15-20cm. Also such condition can be detected on CT-scan or MRI (MRCP) of abdomen when done to evaluate chronic pancreatitis. If size of such cyst is so huge to develop abdomen to bulge then it look like swelling JUST BELOW xiphoid process but not on the xiphoid process.

Hope I have answered your question. If you have any further questions I will be happy to help

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Happykumar Kagathara (7 days later)

It actually looks now almost like there's a lump on my xiphoid, that gets thinner and goes up my sternum a little, but the only noticeable part seems to be right on my xiphoid. Even though it all started that day, and I have had multiple episodes of pancreatitis since, for the same reasons. I do think they tested me with whatever scan that is, covered my stomach in gel and ran a thing over me. Does it usually go away on it’s own eventually?

Answered by Dr. Dr. Happykumar Kagathara (6 hours later)

Brief Answer:
Pancreatic lump never go up on sternum

Detailed Answer:
Hello,
I apologize for late reply.
1) If that lump is due to pancreatic pathology then it never go up on sternum. It must be restrained below the xiphoid process.
2) If that lump is due to pseudo-cyst formation (sequel of acute episodes of chronic pancreatitis) then generally lump 5 cm then based on symptoms, location of lump, surgery can be planned.
3) I guess they did USG abdomen (use of gel). But as I mentioned, chronic pancreatitis require further precise and more detailed evaluation with contrast enhanced CT scan abdomen.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Happykumar Kagathara (3 days later)

Any idea what else it could be?

Answered by Dr. Dr. Happykumar Kagathara (16 hours later)

Brief Answer:
It may be costo-chonditis

Detailed Answer:
Hello,
I apologize for late reply,
I am not sure about swelling typically over the sternum but it might be costo-chondritis and require consultation of thoracic surgeon for further evaluation.
As a abdominal surgeon, I can not provide guidance on typical sternum swelling as it is beyond my expertise.

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Above answer was peer-reviewed by : Dr. Yogesh D