This 88 year old female had severe nausea and could not tolerate food due to a mass in the small bowel from a progressive pancreatic cancer.
Pancreatic cancer is usually due to a ductal adenocarcinoma of the pancreas (including its subtypes).
More than 95% of malignant neoplasms of the pancreas arise from the exocrine elements and are referred to as exocrine pancreatic cancers.
The most common presenting symptoms in patients with exocrine pancreatic cancer are pain, jaundice and weight loss.
Initial investigations include imaging, such as right upper quadrant ultrasound, endoscopic retrograde cholangiopancreatography (ERCP), or magnetic resonance cholangiopancreatography (MRCP). Endoscopic ultrasound may be of use in a patient suspected of pancreatic cancer based on clinical presentation but without a mass on initial imaging.
In this patient, on endoscopy, extensive food residue in the stomach was removed and a metal stent inserted into the duodenum to allow the patient to eat.
Further diagnostic evaluation and staging could then be performed whilst facilitating oral intake.
