Unresectable Pancreatic Adenocarcinoma: Eight Years Later
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Case Report :
A 73-year-old male with a history of palliative choledochojejunostomy for unresectable pancreatic adenocarcinoma 8 years prior presented to our emergency department with a 2-day history of vague abdominal pain, malaise and subjective fevers. Laboratory testing demonstrated an elevated white blood cell count of 13.9 × 103/?L and normal liver function tests and chemistry panel. As part of his diagnostic workup, a CT scan of the abdomen and pelvis was obtained, which demonstrated diffuse thickening of the hepaticobiliary limb concerning for a functional afferent limb syndrome due to bacterial overgrowth. The patient was admitted to the surgical care unit and treated with a course of levaquin and flagyl. His symptoms and leukocytosis quickly resolved and he was discharged to home on hospital day 2....

http://wjon.org/index.php/wjon/article/view/957/716
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