Korean J Helicobacter Up Gastrointest Res.  2016 Mar;16(1):42-45. 10.7704/kjhugr.2016.16.1.42.

Pancreatitis-Mimicking Pancreatic Cancer with Duodenal Obstruction: A Case Report

• Choe AR
• Shim KN
• Kim TO
• Yoon SE
• Min SK
• Cho MS

• KMID: 2159124
• DOI: http://doi.org/10.7704/kjhugr.2016.16.1.42

Abstract

Pancreatic cancer tends to be delayed in diagnosis because of the lack of early symptom and less than 20% of patients present with resectable masses. A 95-year-old male visited due to recurrent abdominal pain and vomiting. About 2 years ago, a polypoid lesion was detected at the post-bulbar area on esophagogastroduodenoscopy for medical check-up. Endoscopic biopsy noted chronic inflammation with glandular atypia. On the CT scan, there was an intraluminal polypoid mass lesion with mixed hypodensity at the duodenal second portion. Ultrasound guided biopsy targeting the hypodense lesion was performed and revealed chronic pancreatitis. The vomiting persisted and the patient received a palliative gastrojejunostomy. Twenty-five days after gastrojejunostomy, jaundice occurred and an ill-defined mass at the pancreas head was noted on the CT. Pylorus preserving pancreatoduodenectomy was performed and a 3.5 cm sized, moderate to poorly differentiated ductal adenocarcinoma of pancreas head was diagnosed. Nineteen days after operation, the patient was discharged in good condition.

Keyword

Pancreatic neoplasms; Pancreatitis; Duodenal obstruction

MeSH Terms

Abdominal Pain
Adenocarcinoma
Biopsy
Diagnosis
Duodenal Obstruction*
Endoscopy, Digestive System
Gastric Bypass
Head
Humans
Inflammation
Jaundice
Male
Pancreas
Pancreatic Neoplasms*
Pancreaticoduodenectomy
Pancreatitis
Pancreatitis, Chronic
Pylorus
Tomography, X-Ray Computed
Ultrasonography
Vomiting