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Goubaa Mohamed MD Djerba Tunisia

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--- Arabic
This is a 67-year-old male with a 3-month history of a 15-pound weight loss and a 1-week history of painless jaundice.Lab work included a bilirubin of 13 and alkaline phosphatase of 420. Look at the ultrasound scans C'est un patient âgé de 67 ans consultant pour une perte de poids de 8 kg et une douleur épigastrique depuis 7jours avec apparition d'ictère. Les analyses de laboratoire ont montré une bilirubine à 13 et des phosphatases alcalines à 420. Regardez les images échographiques.

 

 

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Scan 1: In the head of the pancreas, a homogeneously hypoechoic mass measuring 16 mm transaxially and 13 mm anteroposteriorly is identified . The mass is directly anterior to the splenic vein-portal vein confluence.
Scan 2: the pancreatic duct (denoted by dots) is very prominent, measuring 7.7 mm in diameter, obstructed by the mass.
Scan 3: Dilated intrahepatic ducts.
Scan 4: Enlarged Duodenum.

All of these findings are most consistent with pancreatic carcinoma.(Confirmed by percutaneous guided biopsy.)

 


Cliché1: Dans la tête du pancréas, une masse hyoéchogène homogène mesurant 16 mm transversalement et 13 mm en antéro-postérieur est identifiée. La masse est en avant du confluent veineux porto-splénique.
Cliché 2: le canal pancréatique (dénoté par des points) est très dilaté, mesurant 7,7 mm de diamètre, obstrué par la masse. Cliché 3: les canaux biliaires intra-hépatiques sont dilatés.
Cliché 4: Duodénum de lutte.

Tous ces clichés sont très évocateurs de carcinome pancréatique (confirmé par une biopsie percutanée).


 

 

 

Carcinoma of the head of the pancreas Carcinome de la tête du pancréas _______

 

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Références
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*10 : Prokesch R. [Pancreatic carcinoma: state of the art imaging]. Wien Med Wochenschr Suppl. 2002(113):67-8. German.
* 11: Wu J, Shao Y, Rong W, Shan Y, Gao J, Wu T. [Diagnosis and treatment of 178 patients with carcinoma of the head of pancreas]. Zhonghua Zhong Liu Za Zhi. 2002 Sep;24(5):497-500. Chinese.
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* 15: Luthen R. [Gastroenterology diagnosis of pancreatic carcinoma]. Schweiz Rundsch Med Prax. 2000 Nov 30;89(48):1993-2001. Review. German.
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*17 :Chang KJ, Nguyen P, Erickson RA: The clinical utility of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of pancreatic carcinoma. Gastrointest Endosc 1997 May; 45(5): 387-93
*18 :Evans DB, Staley CA, Lee JE: Adenocarcinoma of the pancreas: recent controversies, current management, and future therapies. Gastrointest Cancer 1996; 1: 149-61.
*19 :Lowenfels AB, Maisonneuve P, Cavallini G: Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med 1993 May 20; 328(20): 1433-7
* 20 :Warshaw AL, Fernández-del Castillo C: Pancreatic carcinoma. N Engl J Med 1992 Feb 13; 326(7): 455-65

 

 

 

 


 
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