USMLE gastro question

[arda]

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A 76-year-old man who has had multiple epi- sodes of pancreatitis presents to his physician’s office with mild epigastric pain and 9.1-kg (20.0-lb) weight loss over the past 6 months. The patient also describes daily foul-smelling stools that “float” in the toilet bowl. The physi- cian pulls up his electronic medical record and finds that the patient presented to the emergency department last week for the same symptoms. During that visit he had a CT of the ab- domen (see image). Which of the following is the most appropriate treatment?

1. (A) Endoscopic retrograde cholangiopancre- atography
   
   
2. (B) Pancreatic enzyme replacement
   
   
3. (C) Pancreaticogastrostomy
   
   
4. (D) Surgical resection of pancreas
   
   
5. (E) Whipple procedure

 

[arda]

i picked A thinking that white thing around the pancreas is a stone and can be treated by ERCP.

Correct answer is B

 

[notbobtrustme]

i picked A thinking that white thing around the pancreas is a stone and can be treated by ERCP.

Correct answer is B

it's a classic picture of chronic pancreatitis, you don't need the CT to answer this. whenever a question mentions multiple episodes of pancreatitis, the first thing you should think of is chronic pancreatitis resulting in a burnt out pancreas.