Difficult diagnosis of an air‐containing, abscess‐like, and mass‐like pancreatic head lesion

Abstract

An otherwise healthy 71-year-old woman presented due to a 4-h episode of mild right-upper quadrant pain. Vital signs were normal and physical examination revealed right-upper quadrant tenderness. Complete blood count was normal, serum amylase five times elevated, and liverassociated enzymes mildly elevated. Ultrasonography revealed the presence of biliary microlithiasis, increased pancreatic volume with a marked decrease in echogenicity, and the absence of gallbladder wall thickening, pericholecystic fluid, and biliary tree dilatation. Interestingly, CT revealed a couple of ill-defined, air-containing, masslike, abscess-like lesions interposed between duodenum and pancreas along with pancreatic head enlargement and peripancreatic inflammatory changes (Figure 1).