A 58 year old woman comes to a general practicioner with several days lasting vomiting, nausea and weakness. She's lost 12 kg in 4 months.She complains of occasional back pain in the lumbar region. The physio revealed icteric skin and soft painless abdomen. Imaging examination (USG, CT) and following biopsy revealed an inoperable tumor of the pancreatic head (T2/N1/M0). The stent was introduced into the biliary tract using ERCP and the patient was handovered to the oncologist. Later she arrives to a pain clinic. At home she's been using ibuprophen gel without help. The pain is barely tolerable.
VAS - Visual Analog Scale, USG - ultrasonography, TNM – tumor – nodulus – metastasis, CT – computer tomography, PO - per os, ERCP - Endoscopic Retrograde Cholangiopancreatography, OD - once a day, BD - twice a day