An indigenous female patient, of 80 years old, is brought to the emergency room of Colta´s

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 Murphy´s 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
páncreas. That is why a ACT was done on November 3rd of 2015, where bile dicts were dilated
with a diameter of 23 mm, the páncreas 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 cáncer 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 cáncer.

Pancreatic cáncer 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 cáncer 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 cáncer:

 Exocrine páncreas cáncer

 Endocrine páncreas cáncer.

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 cáncer can recieve trhee types of treatment.

1. Surgery: Surgery has two main objectives, partially extract tumors located in the head
of the páncreas 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.