Pancreatic Cancer: A Continuing Diagnostic Dilemma

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An increasingly common clinical problem is that of the patient with abdominal pain who is suspected of having a pancreatic cancer but in whom results of routine laboratory tests and barium examination of the intestinal tract are normal. At this point, more extensive testing is done, usually including ultrasonography or computed tomography (CT), or both, and perhaps endoscopic retrograde pancreatography, pancreatic function testing, or arteriography. Eventually, laparotomy is undertaken and the patient is found to have unresectable pancreatic cancer. This common unfortunate outcome raises several important questions. How frequent is pancreatic cancer? Why do these patients have unresectable disease? What

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