82 years old patient comes to adjustment of diabetes type 2
2003 CABG and post-insult
1994 Aortic prosthesis

Age-appropriate findings on admission

Sonography (clarification of elevated CRP): Not clear mass in pancreatic head 4x3x6 cm:

ERCP: Fish mouth-like papilla with emptying of gelatinous fluid. Oral of the papilla polypoid mass in the duodenal wall with gelatinous secretion. After exploration, the ERCP catheter leaks out in the above-named area.

The contrast medium administration shows large cut-outs in the visible bile duct. The presentation of the bile duct systems above the perforation site is not successful.


IPMN with duodenal perforation


A further clarification was rejected by the patient in the absence of complaints and advanced age.