A case report

• Dr.Raad S. Alsaffar ,M.B.Ch.B, C.A.B.S., senior surgeon and lecturer in general surgery, department of surgery and gasterointestinal center in Al-Sadur teaching hospital, Al-Najaf, Iraq.
• Dr.Ahmed R. Jawad ,M.B.Ch.B. ,C.A.B.S., surgeon in gastroenterology, department  of surgery and gasterointestinal center in Al-Sadur teaching hospital, Al-Najaf, Iraq.
• Dr.Liwaa H. Al-Kilaby,M.B.Ch.B ,F.I.B.M.S.path. lecturer in pathology, department of pathology,Kufa college of medicine, Al-Najaf, Iraq.

Introduction

Pancreatic cancer incidence has risen steadly over the last 25 years.the disease is adisease of ageing,and it affects men and women to the same degree.

Predisposing factors are tobacco smoking and chronic pancreatitis.

More than 85% of cases are duct cell adenocarcinoma.the most common symptoms are non soecific, namely epigastric pain, anorexia and weight loss.often the patient becomes aware of the digestive system for the first time, and such is the mildness of the initial symptoms that they are frequently dismissed by both patient and doctor.

Case report

26 years old female patient presented to GIT center in Al-Sadur teaching hospital in Najaf, complaining from epigastric pain referred to the back and anorexia for the last three months.investigations were done including ultrasonography( revealed small mass in pancreatic head 3×3 cm),upper gasterointestinal endoscopy(was normal), abdominal CT-scan(native and contrast,revealed pancreatic head mass 2.8 ×2.5 cm, otherwise normal abdominal organs),EUS: endoscopic ultrasound( also revealed pancreatic head mass 2.8 ×3 cm, but needle biopsy was not feasible) and liver function tests were within normal.

The patient undergone pancreaticodoudenectomy(classical Whipple’s operation),with uneventfull postoperative course.

The histopathological diagnosis was moderately differentiated adenocarcinoma of pancreatic head,invading duodenal smooth muscle,and all lymph nodes were free of metastasis.(T2N0MX), STAGE IB.

Conclusion

The interesting points in our case are, the patient is young which is unusual in pancreatic cancer, early diagnosis that allow to do curative surgical resection possible and perfect surgical procedure that made patient pass in smooth and uneventful postoperative course.

References

Beger, H.G.,  Warshaw, A.L., Buchler,  M. W., Russell, R.C.G. and Sarr, M.G.(eds)(1998) The Pancreas. Blackwell Science, Oxford.

Johnson, C.D. and Imrie, C.W.(eds)(1999) Pancreatic Disease. Springer, London.

Trede, M. and Carter, D.C.(eds)(2007) Surgery Of The Pancreas. Churchill Livingstone, Edinburgh.