A Multisystem Illness Involving Pancreas, Bile Ducts, and Salivary Glands

Venu Julapalli, MD; Daniel Ball, MD; Ravi Shivshankar, MDSeries Editor: Richard Goodgame, MD

Disclosures

June 17, 2005

Diagnostic Questions

The goal of describing this patient's complicated course is to aid the clinician in recognizing the disease underlying these clinical findings. There are 3 clinical situations that should prompt the consideration of this elusive diagnosis. The diagnostic questions below serve to emphasize these clinical "prompts."

What is the cause of the unusual appearance of the pancreas in this patient's MRI (Figure 11)?

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What is the relationship between the pancreatic disease and the 2 other aspects of this patient's illness -- the biliary and salivary findings?

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What should be the reflexive diagnostic response when suspected pancreatic cancer is accompanied by a negative biopsy?

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