In Carcinoma head of pancreas, Nausea & vomiting is due to
a) External Compression of duodenum
b) Portal vein infiltration
c) Proliferation infiltration of tumor into duodenum
d) Chemotherapy related
Ans: A Reference: Blumgarts 6th ed; pg. 979; Sabiston 20th ed; pg. 1544 Explanation:
• Pancreatic adenocarcinoma develops in the ductal cells and are called Ductal Adenocarcinoma. • They most commonly occur on the Right side, ie, Head and Uncinate Process (60-70%) than left side, ie, Body and Tail of pancreas (20-25%) • Features of Carcinoma Head of Pancreas are Jaundice 75% Weight loss 51% Abdominal pain 39% Nausea/vomiting 13% Pruritus 11% Fever 3% Gastrointestinal bleeding 1% • For tumors at the body and tail of pancreas, Pain(most common) and weight loss are the presenting features as they present at a late advanced stage • Regarding Nausea and vomiting, they occur due to tumor extrinsic compression of duodenum C loop presenting a state of Gastric outlet obstruction. • In unresectable cases, these patients should be offered Endoluminal duodenal metal stent as palliation.