A 62-year-old man came to the ED (emergency department) with complaints of fatigue, weight loss, jaundice, and anorexia. Diagnostic studies including abdominal CT with contrast, ERCP, and EUS were performed. The CT scan showed a resectable 4-cm mass at the head of the pancreas, and ERCP revealed evidence of bile duct obstruction; a stent was placed to open the duct. Examination of a tissue biopsy specimen obtained under U/S guidance confirmed an adenocarcinoma of the head of the pancreas. Additional studies showed no evidence of hepatic or other metastases. Surgical treatment with a Whipple procedure was recommended. This procedure was performed and included pancreatoduodenectomy, choledochojejunostomy, and gastrojejunostomy. Lymph node removal and cholecystectomy were part of the operative procedure. During surgery, it was determined that the tumor was confined to the head of the pancreas. Despite removal of the tumor, the chance of recurrence is high, with a cure rate of only about 20%. What caused the patient’s jaundice? Cholelithiasis Bile duct obstruction Viral hepatitis Excessive hemolysis
A 62-year-old man came to the ED (emergency department) with complaints of fatigue, weight loss, jaundice, and anorexia. Diagnostic studies including abdominal CT with contrast, ERCP, and EUS were performed. The CT scan showed a resectable 4-cm mass at the head of the pancreas, and ERCP revealed evidence of bile duct obstruction; a stent was placed to open the duct. Examination of a tissue biopsy specimen obtained under U/S guidance confirmed an adenocarcinoma of the head of the pancreas.
Additional studies showed no evidence of hepatic or other metastases. Surgical treatment with a Whipple procedure was recommended. This procedure was performed and included pancreatoduodenectomy, choledochojejunostomy, and gastrojejunostomy. Lymph node removal and cholecystectomy were part of the operative procedure. During surgery, it was determined that the tumor was confined to the head of the pancreas. Despite removal of the tumor, the chance of recurrence is high, with a cure rate of only about 20%.
What caused the patient’s jaundice?
Cholelithiasis
Bile duct obstruction
Viral hepatitis
Excessive hemolysis
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