Shumaila Seemi Malik, Safdar Ali Malik, Muhammad Bin Zulfiqar, Adila Iqbal.
Moderately differentiated ductal carcinoma pancreas involving periampullary region.
Ann King Edward Med Uni Jan ;21(2):119-24.

Background: Pancreatic carcinoma has very poor prognosis. Curative management is only surgery. It is documented in literature studies that only 10 – 15% of patients suffering from adenocarcinoma go for surgical resection and surgery is radical in about half of these cases.1 In this case we will discuss that how imaging, ultrasonography in usual and CT in particular are used to identify patients with probable resectable tumors. Methods: We report a case of 65 years old man who referred to us for imaging from surgical emergency department with complains of obstructive jaundice. Ultrasonography revealed a hypo echoic mass in periampullary region with dilatation of common bile duct, Intra hepatic biliary channels, pancreatic duct and distension of Gall Bladder. CT scan showed a hetero-geneously enhancing mass in periampullary region in relation to head of pancreas. There was no evidence of any vascular invasion. Results: The patient underwent pancreaticoduodenectomy according to Whipple’s procedure. Histological examination of the specimen proved a moderately differentiated ductal adenocarcinoma of the pancreas. Conclusion: With the help of imaging USG in usual and CEMDCT in particular, a radiologist can play major role to guide surgeon about resectability of tumor, while describing the involvement of surrounding structure and size of tumor.

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