201011212

the sentences to reconstruct the case report

A, I U- had hepatilis A when he was l~ ycars old.

I' lathrr was killed in a road accident. Mother had adult-onset diahetes and an Ml ai the age of 62 ycars. His rwo sisters were wcII, Th*- tnaternal grandfather had died of "Iiver tumom”

C% Ihc patiem was prepared for Whipples opcration howew the prognosis was poor.

d.    Ile smokcd 20 cigarettes daily and had an occasional beer.

e,    Ihc Iungs were elear o auscultation and percussion. The heart apes was identiHcd in the 5ISMCL.

1, 1 te worked as a police detective. He livcd with his wife and three children who were well.

g.    His generał practitioner had diagnosed duodenal uleer and ovet several years had treated him with antacids.

h.    On presentation he looked unwell, was very thin and slgnlfieanrly jaundlced.

I, Ahdominal examination revealed tenderness, rebound tenderness and lnvolt ntary muscle guąrding. The gali hladder was palpable. There was no board-likc rigidity und no ascitcs,

j,    A Sł-ttar-old man was admitted to hospital with a ml Id eplgastric pain, nausea. He denied vomiting, but admitted to having hud dark urinc and pale stools which "wouldn’t flush away" .

k,    DlagltOStlc itwestigatinns were immediately performed.

l.ahorntory rcsults, no Jominal USG, ERCP and CT were eonsistent with tancer of the head of the panereas.

l,    The Immediate postoperative course was uneventful. lite WOUItd healed by the first intention. Ihc patiem was dischargcd ho me on pancrcatic enzymc snpplementation.