Case Presentation

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Case 1

A 56-year-old man, an alcohol user, presented with a 1-month history of mild acute pancreatitis and obstructive jaundice, followed by increasing general fatigue and severe epigastric pain. CT showed a mass in the head of the pancreas (fig. 1). ERCP demonstrated a smooth stricture of the intra-pancreatic main bile duct and an irregular, incomplete, stricture in the main pancreatic duct (fig. 2). There were no definitive criteria for pre-operative diagnosis. Intraoperative histopathogical examination using a frozen section of the pancreas was performed to rule out a carcinoma. The diagnosis was chronic pancreatitis and no features of cancer were seen (fig. 3). The patient underwent a biliary stent placement in the common bile duct via Vater's papilla, which procedure provided a good outcome with recovery of bile duct drainage and complete pain relief. The histologic diagnosis of the paraffin sections was chronic pancreatitis. The patient had an uneventful postoperative course until his death in a traffic accident 2 years later.

Fig. 3. Chronic pancreatitis (frozen section; HE).

Case 2

A 44-year-old man, with a history of alcohol abuse, presented with a 3-day history of nausea, vomiting and general fatigue after heavy drinking. In the hospital, anemia was noted. An endoscopic examination disclosed a marked thickening of the duodenum (fig. 4). ERCP showed narrowing of the intrapancreatic common bile duct (fig. 5). Ultrasonography and CT demonstrated a mass lesion in the pancreatic head. A duodenal cancer could not be excluded, and he underwent a pancreatoduodenectomy. Intraoperative histopathogical examination using a frozen section of pancreas was not performed. The histologic diagnosis of the resected specimen was chronic pancreatitis and Brunner's gland hyperplasia (fig. 6). The lumen of the common bile duct was narrowed by marked fibrosis. The Santorini duct was dilated and contained protein plugs. The postoperative course was uneventful.

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Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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