An indigenous female patient, of 80 years old, is brought to the emergency

room of Coltas hospital with a continous abdominal pain, located in the

epigastrium and right hipocondrio, that irradiates to the back, of moderate
intensity, that gets worse 6 hours ago, without any apparent reason.
Nothings seems to bring it up, like food, or any special position. The patient
also presents nausea that does not lead to vomiting, and constipation 6
days ago, also anorexy. Along side this symptoms, she presents severe
jaundice 4 weeks ago, and finally progressive weight loss during the last
months. The patient does not have any other importance atnecedents.
At the physical exam could be found: non distended abdomen, present
hydroaereal sounds, painful to te deep palpation. Positive Murphys and
Desjardins signs. A mass can e located in the epigastrium. To the percussion
mate sound could be found. Kidney percussion negative. No edema in the
patients limbs.
The patient gets hospitalized on October 30th of 2014, lab exams as well as
a chest x ray get done, which didnt allow the doctors to get to the diagnose.
An abdomen ultrasound was realized where doctors could see gallblader
pathology as well as an unidentified mas son the pncreas. That is why a
ACT was done on November 3rd of 2015, where bile dicts were dilated with
a diameter of 23 mm, the pncreas showed a mass of 50mm by 33 mm as
well as pancreatic calcifications.
Biopsy and surgicall extraction could not be made, so a transfer to intesive
care was made.
The patient enters intesive care unit after 4 days of hospitalization, artificial
breathing methods were used. After this the patient died due to a depletion
of the cardiorespiratory function.
Pancreatic cncer does not have a high prevalence in population. However
its mortality is very high. In Europe almost 78 000 cases were reported and
32 000 cases in USA. In spain 2 400 men and 2 000 women die due to this
cncer.
Pancreatic cncer ussually appears between 65 and 70 years, and is very
rare under 60 years. In the momento of the diagnose less tan 20% of the
patient would susceptible for operation due to the advanced stage of the
disease.
Ethiology of this cncer is unkkown but some risk factors can be identified:

Genetics.
Age.
Sex.
Ethie.
Tobacco consuption
Diet habits
Diabetes.

The symptomatology can be very different deppending on where the tumor

would be located.

According to some speciallists there are two types of cncer:

Exocrine pncreas cncer

Endocrine pncreas cncer.

The Spanish Oncology society says that when a patient presents jaundice,
altered glucose levels, and abdominal pain, tests should be done to
investigate this pathology.
Bilirubin levels should be analyzed to detect any alteration in bilirubin
elimination.
Secondly, tumoral markers should be checked like CA 19,9, Isolated
elevations dont make the diagnose but can make suspect of the pathology.
The third test should be a thoracoabdominal CT, and finally a magentic
resonance.
Patients with pancreatic cncer can recieve trhee types of treatment.
1. Surgery: Surgery has two main objectives, partially extract tumors
located in the head of the pncreas by doing a cephalic
duodeopancreatectomy, and extract those located in the body and
tail of the pacnreas by a partial pancreatectomy.
2. Chemotherapy.
3. Radiotherapy.