A 55 year-old woman with epigastric pain, flatulence for 2 months that failed in gastric management. Two days before she vomited out the old gastric contents.
Ultrasound detected a dilated stomach and obstruction of extra and intrahepatic biliary ducts which may due to pancreatic head tumor #30x35 mm. CBD dilated # 15-17mm in diameter.
Lab data showed increased CA 19.9.
MSCT confirmed head of pancreas tumor which made obstruction of biliary ducts and the stomach in dilatation.
Open surgery was done for removing the pancreatic tumor and performing the gastroenterology anastomosis and common bile duct- ileum anastomosis.
Result of pathology was adenocarcinoma metastasized duodenum, transverse colon and lymph node.
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