@article{Malik_Malik_Zulfiqar_Iqbal_2015, title={MODERATELY DIFFERENTIATED DUCTAL CARCINOMA PANCREAS INVOLVING PERIAMPULLARY REGION}, volume={21}, url={https://annalskemu.org/journal/index.php/annals/article/view/709}, DOI={10.21649/akemu.v21i2.709}, abstractNote={<p><strong>Abstract</strong></p> <p><strong>Background:  </strong>Pancreatic carcinoma has very poor prognosis. Curative management is only surgery. It is documented in literature studies that only 10 - 15% of patients suffering from adenocarcinoma go for surgical resection and surgery is radical in about half of these cases.<sup>1</sup> In this case we will discuss that how imaging, ultrasonography in usual and CT in particular are used to identify patients with probable resectable tumors.</p> <p><strong>Methods:  </strong>We report a case of 65 years old man who referred to us for imaging from surgical emergency department with complains of obstructive jaundice. Ultrasonography revealed a hypo echoic mass in peri-ampullary region with dilatation of common bile duct, Intra hepatic biliary channels, pancreatic duct and distension of Gall Bladder. CT scan showed a hetero-geneously enhancing mass in periampullary region in relation to head of pancreas. There was no evidence of</p> <p>Malik S.S.<sup>1</sup></p> <p>Associate Professor</p> <p>Department of Radiology, AIMC / Jinnah Hospital, Lahore</p> <p>Malik S.A.<sup>2</sup></p> <p>Professor of Radiology, SIMS / Services Hospital, Lahore</p> <p>Zulfiqar M.B.<sup>3</sup></p> <p>Dept of Radiology, Services Hospital, Lahore</p> <p>Iqbal A.<sup>4</sup></p> <p>Department of Radiology, Services Hospital, Lahore</p> <p>any vascular invasion.</p> <p><strong>Results:  </strong>The patient underwent pancreaticoduodenec-tomy according to Whipple's procedure. Histological examination of the specimen proved a moderately dif-ferentiated ductal adenocarcinoma of the pancreas.</p> <p><strong>Conclusion:  </strong>With the help of imaging USG in usual and CEMDCT in particular, a radiologist can play major role to guide surgeon about resectability of tumor, while describing the involvement of surround-ing structure and size of tumor.</p> <p><strong>Introduction:  </strong>Incidence of Pancreatic carcinoma is 6-7 per 100,000 per year in Western Europe. Among these most common (85%) are ductal adenocarcinoma, have male predominance (male: female 1.5:1) and usually occur above 6<sup>th</sup> decade of life.<sup>2</sup> Whether tum-ors are small or large, majority (above 80%) are un-resectable at time of diagnosis due to advance local extension (40%) and distant metastasis in Liver and Lymph nodes.<sup>3</sup> Computed tomography (CT) is the imaging investigation of choice as it is easily available and highly sensitive and specific to diagnose and stage pancreatic adenocarcinoma.</p> <p><strong>Key Words:  </strong>Periampullary, Tumor resectability, pan-creatic mass.</p> <p><strong>Abbreviations:  </strong>CEMDCT (Contrast Enhanced Multi Detector Computed Tomography), CBD (Common Bile Duct), IHBC (Intra Hepatic Biliary Channels), MPR (Multi Planar Reconstructions), MIP (Maximum Intensity Projection).</p>}, number={2}, journal={Annals of King Edward Medical University}, author={Malik, Shumaila Seemi and Malik, Safdar Ali and Zulfiqar, Muhammad Bin and Iqbal, Adila}, year={2015}, month={Aug.}, pages={119} }