http://www.appliedradiology.com RSS Feed on Applied Radiologyhttp://www.appliedradiology.com//Issues/2000/02/Cases/Metastatic-adenocarcinoma-of-the-pancreas.aspx<p>She was admitted for liver failure. Admission lab work revealed a total bilirubin of 20.4 mg/dL (normal 0.1-1.2 mg/dL) and an alkaline phosphatase of 2620 U/L (normal 40-130 U/L). A CT scan (figure 1) showed gross ascites, a 4 × 4 cm pancreatic mass which invaded the lesser sac and occluded the portal vein, massive abdominal varices, extensive retro-peritoneal adenopathy, and a common bile duct that was 2.1 cm in diameter. Suspected bilateral deep venous thromboses were confirmed by ultrasound.</p> <p>The patient was referred for percutaneous trans-hepatic cholangiography (PTHC) and possible percutaneous biliary drainage. At PTHC, the intrahepatic biliary system was noted to be irregular and had a beaded appearance (figure 2). The patient's condition deteriorated quickly over the next few days and she died shortly thereafter.</p>Tuesday, 22 Mar 2005 15:41:45 GMT