Abstract
Question: A 38-year-old man presented with recurrent episodes of epigastric pain radiating to the back for 1.5 years duration, with vomiting and weight loss for the past 4 months. He was a smoker with a significant history of alcohol consumption. General physical examination was unremarkable. Investigations revealed anemia, raised serum amylase and alkaline phosphatase with a normal CA 19-9. Ultrasound abdomen showed a dilated common bile duct (CBD) and main pancreatic duct (MPD). Contrast-enhanced computed tomography (CT) revealed a heterogeneous hyperdense enlargement of the head and uncinate process of the pancreas with duodenal wall thickening, cystic hypodense areas in the region between duodenal second part (D2) and head of pancreas, with dilatation of the MPD and CBD (Figure A–C).
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