A mass of approximately 21cm size in the region of pancreatic head was cashing obstructive symptoms in this 78 year old gentleman. He had also developed fever. His CT scan showed a dilated pancreatic duct (A1: green arrow) with abrupt obliteration of its lumen (A2: green arrow) with an adjacent mass in the pancreatic head (A2: red arrow). On ERCP, his cholangiogram showed significant intrahepatic biliary dilatation (B: white arrows) with a stricture involving the distal CHD and proximal CBD (B: green arrows). He was in good physical shape and the remaining CT films didn't show any contraindications to resection. We placed a 10cm long plastic stent of 10 French diameter to drain the biliary system and resolve the infection (C: white arrows). He is due to undergo surgery soon after.
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