Classical symptoms are painless jaundice, weight loss, and back pain (70-90%). Anorexia is present in 60%. It may present with:

Diabetes mellitus

♦ Acute pancreatitis

♦ Cholangitis

♦ Deep-vein thrombosis Signs of pancreatic cancer are:

♦ Palpable gall bladder (Courvoisier's sign—40%)

Epigastric masses, ascites, and abdominal tenderness are common. Rare signs include:

♦ Trousseau's syndrome (migratory thrombophlebitis)

♦ Troisier's sign (left supraclavicular lymph-node enlargement)

♦ Splenic-vein thrombosis

♦ Gastric fundal varices

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