Portal hypertension as an early manifestation of carcinoma of the pancreas

Massive hematemesis followed by 48 hours the onset of obstructive jaundice in a previously asymptomatic 38-year-old male patient. Splenomegaly was the only abnormal physical finding. Esophagoscopy visualized bleeding varices. The liver scan was normal. Dilated intra- and extrahepatic bile ducts and a possible retroperitoneal mass were demonstrated by ultrasonography. Laparotomy disclosed the presence of a carcinoma of the head and body of the pancreas that obstructed the common bile duct and the portal vein. This case report should draw attention to the vast spectrum of rare presentations of pancreas carcinoma.