Pseudopancreatic cyst/WON

HTN, T2DM, DKA, sepsis,chronic pancreatitis- WON/Pseudo-pancreatic cyst under Ix Chief Complaints A 50 yr old female attended Emergency with SOB, 3 episodes of vomiting and unable to pass stool since 3 days. No associated chest pain,fever, cough, dysuria, abdominal pain etc. K/C/O HTN, T2DM- Drug defaulter and taking ayurvedic medicine since long time for unknown cause. No past H/O Thyroid disorder, substance abuse, operative history and Normal Menstrual cycle. Past H/O Acute pancreatitis few months back. O/E pt was dyspenic . Pallor present, rest general examination was normal. Systemic Examination was normal except palpable non tender mass in abdomen which was not so Obvious. Routine Ix were done showing Hyperglycemia with ketone body positive in urine, Raised TLC, raised BP of 180/80.CRP positive, raised ESR, few yeast cells in urine, raised HbA1C of 11,normal Amylase n lipase level. Usg W/A suggestive of Pancreatic mass with surrounding Edema. Conservative management has been started n CECT Abdomen has been planned.

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Yes pancreatic mass is likely malignant tumor Past episode of acute pancreatitis do give rise pseudo pancreatc cyst A c/o hyperglycemia with positive ketone bodies and hba1c 11 is suggestive of DKA Mx will to correct DKA and control of diabetes with insulin Broadspectrum antibiotics inj piperacillin+inj tazobactum Inj Ceftriaxozone Inj dexamethasone Inj lasix Mass biopsy is advisable

A case of Pancreatic mass with surrounding oedema in a case of Chronic Pancreatitis. The possibilities could be 1 pseudo pancreatic cyst 2.Pancreatic tumour Further investigations required are 1.CECT abdomen 2.A MRCP

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