Background/objective Tropical chronic pancreatitis (TCP) is common in developing countries and is defined as a juvenile form of chronic calcific non-alcoholic pancreatitis. Pseudocysts occur in 20–40% of chronic pancreatitis. TCP with pseudocyst has not been reported yet, so we represent this rare case to broaden the horizons regarding pancreatitis. Case presentation A 16-year-old woman suffered a painful lump in the upper abdomen. She came from a low-income family and frequently consumed cassava. There was intolerance of glucose in which admission blood sugar level of the patient increased by 179 mg/dl. An abdominal CT scan showed a mass around the pancreas, 20 cm in diameter, and located in retro-gastric. There were multiple ductal calculi along the major pancreatic duct with the largest stone was 3 cm in the pancreatic head. Longitudinal pancreaticojejunostomy (Partington-Rochelle procedure) has been performed and histopathological results appropriate with a pancreatic pseudocyst. Clinical discussion TCP with a giant pseudocyst is an interesting case report that has not been reported yet. This case met the clinical characteristics of TCP, such as young women, malnourished, history of cassava consumption, abdominal pain, and intolerance of glucose. A surgical intervention provides a satisfactory result to the patient. Conclusion Tropical chronic pancreatitis is a rare case. A pseudocyst adds the uniqueness of this case that has never been reported before. Appropriate management can provide satisfactory results and improve the quality of life for patients.

Obstructive jaundice can cause liver function damage which exacerbates patient morbidity and mortality. Fermented milk starter Lactococcus Lactis D4 derived from dadih is a probiotic that has the potential to improve liver function through the enterohepatic pathway. The research would like to determine the effect of Lactococcus Lactis D4 starter fermented milk on liver function of obstructive jaundice. This study was an experimental study with a post test only randomized control group design in 3 groups of Rattus Novergicus strain Wistar rats with obstructive jaundice model which got ligation of biliary ducts and given Lactococcus lactis D4 starter fermented milk for 7 days. Liver function was assessed by looking at the levels of total bilirubin, SGOT, SGPT, ALP, and GGT in each treatment group. Administration of Lactococcus Lactis D4 starter fermented milk caused a decrease in SGOT levels (LDB + BAL vs LDB: 51.12 ± 1.77 U/L vs 64.63 ± 0.10 U/L, p<0.05) and SGPT (LDB + LAB vs LDB: 60.60±0.85 U/L vs 67.77±2.60 U/L, p<0.05) which was significant. However, there was no significant effect on total bilirubin levels (LDB + BAL vs LDB: 3.21±0.11 mg/dl vs 3.18±0.10 mg/dl, p>0.05), ALP (LDB + LAB vs LDB: 108.20 ± 2.78 U/L vs 115.38 ± 5.08 U/L, p>0.05), and GGT (LDB + LAB vs LDB: 12.57 ± 0.45 U/L vs 12.78±0.31 U/L,  p>0.05). Lactococus Lactis D4 starter fermented milk can improve liver function which is indicated by a decrease in SGOT and SGPT levels in experimental animals.