Relapsed acute pancreatitis as the initial presentation of pancreatic cancer in a young man: a case report.
In this report, we describe a 31-year-old man in whom acute pancreatitis was the initial feature of a subsequently diagnosed pancreatic adenocarcinoma with multiple metastases. He initially presented at our hospital with acute pancreatitis. Abdominal ultrasonography revealed a mildly dilated pancreatic duct and an enlarged pancreatic head. Although a follow-up abdominal ultrasonography revealed a progressively dilated pancreatic duct and a progressively enlarged pancreatic head, he refused further investigation and was lost to follow-up. Four months later, he returned to our hospital with relapsed acute pancreatitis. Obstructive jaundice was noted and drainage was performed. Because choledochoplasty with multiple balloon catheters was not fully effective, biliary tract bypass surgery was carried out. Intraoperative biopsy confirmed pancreatic adenocarcinoma with multiple metastases. The patient died of massive gastrointestinal bleeding a few weeks later. To our knowledge, this is the youngest case of pancreatic cancer with the uncommon initial presentation of acute pancreatitis reported in the literature. For a patient with acute pancreatitis, particularly recurrent episodes, but with no known risk factors for pancreatitis, a pancreatic neoplasm should be considered as a potential underlying cause, even in a young man.
Tsai
Ming-Ju
MJ
Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Liao
Kuo-Sheng
KS
Shih
Paul Ming-Chen
PM
Lee
King-Teh
KT
Chuang
Wan-Long
WL
Chiu
Yu-Jui
YJ
Lin
Zu-Yau
ZY
D000208:Acute Disease / Q000628:therapy; D000328:Adult; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012008:Recurrence; D014463:Ultrasonography