A 74-Year-Old Farmer with Abdominal Pain | Figure 1
A 74-Year-Old Farmer with Abdominal Pain
A 74-year-old grain farmer comes to your office for assessment of abdominal pain of 6 months’ duration. The pain is located in the central abdomen with radiation through to the back. It is a dull, constant pain with no significant aggravating or relieving factors. It is not affected in any way by food. It is rated by the patient as a 5/10 baseline with occasional increases to 7/10. It has been getting worse for the past 2 months.
On examination, vital signs are stable, but the sclerae are slightly icteric. The abdomen is scaphoid. The liver margin feels slightly irregular 2 cm below the right costal margin. No other masses are felt. Abdominal ultrasound examination reveals a solid mass lesion in the area of the head of the pancreas measuring 4 cm. There are also two or three nodular densities (1 cm each) in the liver.
What is the most likely diagnosis in this patient?
- a. benign pseudocyst of the pancreas
- b. adenocarcinoma of the pancreas
- c. squamous cell carcinoma of the pancreas
- d. pancreatitis
- e. malignant pseudocyst of the pancreas
Question from Swanson’s Family Medicine Review, 8th edition. ISBN: 9780323356329. Copyright ©2017 Elsevier, Inc.
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