PMC2373905_01
ERCP films show the proximal common bile duct stricture and dilated
distal biliary tree.
HPB2008-374602.001.jpg
PMC2373905_01_HPB2008-374602.001.jpg
fig1
At ERCP, the CBD was cannulated, the biliary dilation was again noted and a 2 cm-long biliary stricture was detected (see Figure 1).
CT with contrast (arterial phase) showing the mass
at the head of the pancreas (PM) and dilated common bile duct (dCBD).
HPB2008-374602.002.jpg
PMC2373905_01_HPB2008-374602.002.jpg
fig2
A CT scan on the same admission confirmed a heterogeneous mass 2 cm in diameter in the pancreatic head (and the biliary dilatation) (see Figure 2).
Pancreaticoduodenectomy resection specimen, showing sectioning (in
the plane of the black dotted line) of the second part of the duodenum (D), the
common bile duct (CBD), the site of the previously impacted gall stone
calculus (IGS), the biliary stricture (blue dotted line) and pancreatic
abscess cavity (PA).
HPB2008-374602.003.jpg
PMC2373905_01_HPB2008-374602.003.jpg
fig3
The macroscopic pathological specimen is shown in Figure 3 below.