Endoscopic Ultra

Sonography (EUS)

Mrs. DW / 58 y.o/ 1021186

30-03-1965
Wahidin Sudirohusodo
Hospital
 Case Description

• Female, 58 years old icterus since a month ago with

Itching for 3 months, weight loss 10 kg in 3 months,
dark yellow urine and pale stool
Laboratory findings
24/7/23 24/7/23
• HGB : 12.1 / WBC : 35.100 / PLT : 363.000 • INR : 1.05

21/7/23 16/5/23
• GOT / GPT :208/211 • HBsAg : Non Reactive
• Anti HCV : Non reactive
12/7/23
• Total Bilirubin : 13.92 16/5/23
• Direct Bilirubin : 11.03 • Ca 19-9 : >200

24/7/23 21/7/23
• Amylase : 34.0 • Creatinine : 0,67
• Lipase : 181.0 • Ureum : 34
16/5/23 Non-Enhanced Abdominal CT-Scan

Intra and extrahepatic cholestasis with hydrops GB and ductus pancreaticus

dilatation ec suspected pancreatic head mass dd/ CBD distal mass
 7/7/23 ERCP

Result:
Duodenal tumor DD/pancreatic tumor
infiltrating the duodenum
Assessment

- Duodenum Tumor ECOG score 2

- Acute cholangitis
Plan

- EUS
- Biopsy
Thankyou