Case of Autoimmune Pancreatitis with Pancreatic Mass with Obstructive Jaundice, Timely Diagnosis Saved from the Major Surgery

Authors: Jagdish RK* and Rastogi M

DOI: 10.23880/ghij-16000202

Volume 8, Issue 1

Abstract

A 68-year-old female presented with a 6 month history of jaundice, epigastric discomfort, anorexia and 4 kg weight loss. Physical examination was unremarkable, except for icterus. Her Liver function tests were deranged. Abdominal computed tomography (CT) revealed pancreatic mass. Magnetic resonance cholangio-pancreatography (MRCP) showed intra hepatic biliary radical dilatation (IHBRD) and Pancreatic mass with double duct sign. Pancreatic malignancy was suspected with increased CA19.9 levels. Endoscopic retrograde cholangio-pancreatography (ERCP) was attempted but cannulation was not possible. Staging laparoscopy and tru-cut biopsy was performed. Histopathology showed plasma cells infiltrates with increased IgG4 suggestive of autoimmune pancreatitis (AIP). Surrounding lymph nodes showed prominent follicular hyperplasia. Patient made an uneventful recovery with steroids, the patient remains asymptomatic with normal liver functions. There is no serological evidence for other autoimmune diseases.

Keywords: Autoimmune Pancreatitis; IgG4 Related Pancreatic Disorder; Mimickers of Pancreatic Malignancy; PTBD; Percutaneous Transhepatic Biliary Drainage

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