In Carcinoma head of pancreas, Nausea & vomiting is due to

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 :black_small_square: Jaundice 75% :black_small_square: Weight loss 51% :black_small_square: Abdominal pain 39% :black_small_square: Nausea/vomiting 13% :black_small_square: Pruritus 11% :black_small_square: Fever 3% :black_small_square: 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.