– 7 year old MN DSH ADR and weight loss

– bloodwork elevated ALT, hyperbilirubunemia, mild neutrophilia, normal HCT

– evidence of EHBDO on ultrasound; pancreas enlarged and hypoechoic

– GB and CBD wall thickened (ddx cholangiohepatitis) ; evidence of IBD vs lymphoma on u/s

– no distinct masses or choleliths seen

DDx: EHBD obstruction due to pancreatiitis/triaditis

The duodenal papilla looks enlarged and swollen to me – is this likely just inflammation or could there be a mass brewing here?

– 7 year old MN DSH ADR and weight loss

– bloodwork elevated ALT, hyperbilirubunemia, mild neutrophilia, normal HCT

– evidence of EHBDO on ultrasound; pancreas enlarged and hypoechoic

– GB and CBD wall thickened (ddx cholangiohepatitis) ; evidence of IBD vs lymphoma on u/s

– no distinct masses or choleliths seen

DDx: EHBD obstruction due to pancreatiitis/triaditis

The duodenal papilla looks enlarged and swollen to me – is this likely just inflammation or could there be a mass brewing here?