title: Relapsed acute pancreatitis as the initial presentation of pancreatic cancer in a young man: a case report.
abstract: 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.
authors: Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors: Ming-Ju
authors: MJ
authors: Tsai
authors: Kuo-Sheng
authors: KS
authors: Liao
authors: Paul Ming-Chen
authors: PM
authors: Shih
authors: King-Teh
authors: KT
authors: Lee
authors: Wan-Long
authors: WL
authors: Chuang
authors: Yu-Jui
authors: YJ
authors: Chiu
authors: Zu-Yau
authors: ZY
authors: Lin
mesh_terms: 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