Introduction Case 1 Case 2 Case 3 Case 4 Case 5 Case 6 Case 2 An 87 year old man was admitted with a 3-4 week history of increasing jaundice, pale stools, dark urine, loss of appetite and lethargy. He had no history of abdominal pain. On examination there was an ill defined mass in the right upper quadrant, thought possibly to be the gall bladder.
Viral hepatitis is less likely.
The palpable gall bladder, accompanied by painless cholestatic jaundice, is very suggestive of carcinoma of the head of the pancreas. LFTs will not differentiate between intra- and extrahepatic cholestasis. Imaging of the liver and pancreas revealed a probable carcinoma of the head of the pancreas.