(Disclaimer: This article is for popular science purposes only. To protect patient privacy, the relevant information in the following content has been processed.) Abstract: The patient in this case presented with vague pain in the upper abdomen with abdominal distension 1 month ago, and considered that it might be a gastric disease, so he took oral gastric medicine on his own for treatment, but the effect was not obvious, and 1 week ago he developed symptoms of yellow urine and decreased appetite, and his skin sclera also gradually turned yellow, and he had obvious itching of the skin, so he He came to the hospital for medical treatment. After examination, she was diagnosed with pancreatic cancer, and her condition was controlled after timely endoscopic drainage. Basic information】Female, 85 years old 【Disease type】Pancreatic cancer, jaundice, abdominal pain 【Hospital】People’s Hospital of Wuhan University 【Visiting time】February 2022 【Treatment plan】Ultrasound gastroscopy-guided fine-needle aspiration biopsy + endoscopic pancreaticobiliary drainage 【Treatment cycle】Hospitalization for 10 days, one-month outpatient follow-up 【Treatment effect】The condition was controlled, abdominal pain and jaundice decreased, and all indicators were The patient had vague pain in the upper abdomen with abdominal distension one month before hospitalization. The pain was not obvious at first, so the patient did not pay attention to it and considered that it might be a stomach disease. The patient came to the hospital accompanied by his family. Outpatient liver function tests indicated: total bilirubin 127.5µmol/L, direct bilirubin 90.7µmol/L, alanine aminotransferase 210U/L, aspartate aminotransferase 189U/L, alkaline phosphatase 578U/L, glutamyl transpeptidase 1027U/L. Ultrasound examination of the liver, bile and pancreas: the bile ducts inside and outside the liver were significantly dilated, the pancreas A 3.0X2.5 cm mass was seen in the head, the echogenicity of the mass was mostly hypoechoic, there were scattered irregular light spots inside with blurred borders, and the pancreatic duct in the tail of the pancreatic body was dilated. We considered the possible presence of malignant tumor of the pancreatic head and cholestatic jaundice, and after communicating with the patient and his family, we arranged for the patient to be admitted to the hospital for further consultation. In view of the patient’s abdominal pain, jaundice, abnormal liver function and pancreatic head mass, it was initially determined that the patient might have a cancer of the pancreatic head compressing the common bile duct and pancreatic duct causing jaundice and abdominal pain. However, histopathological evidence was needed to confirm the diagnosis, so we fully communicated with the patient and his family and performed ultrasound gastroscopy-guided fine-needle aspiration biopsy on the pancreatic mass under intravenous anesthesia, removed the tissue for pathological examination, and diagnosed the pancreatic mass as pancreatic cancer. The first choice of treatment was surgical resection, and later chemotherapy and biologic targeted therapy were administered to treat the tumor. However, since the patient was old and pancreatic cancer surgery is very traumatic, we decided to perform endoscopic pancreaticobiliary drainage to relieve jaundice and abdominal pain first, and then proceed to the next step of oncological drug treatment after the condition is stabilized. Endoscopic pancreaticobiliary drainage is a minimally invasive procedure, and the patient can basically tolerate the surgery. The patient and her family agreed to the treatment plan, and endoscopic pancreaticobiliary drainage was performed under intravenous anesthesia. After the operation, because of the pancreatic duct drainage, the pressure in the pancreatic duct was reduced and the abdominal pain was significantly relieved. After the bile duct drainage, the liver function recovered rapidly and basically returned to normal, and the patient was discharged from the hospital at 10 days. The patient was discharged at 10 days of hospitalization. One month after discharge, the patient’s liver function was basically normal in the outpatient follow-up examination, and there was no abdominal pain and jaundice, and the patient was recommended to undergo chemotherapy and biologic targeted therapy, and regular outpatient follow-up to observe the changes in liver function and tumor size. 4. Precautions We are glad that the patient’s condition has been effectively relieved after surgical treatment. We suggest that the patient should continue to pay attention to the changes of abdominal pain and appetite after discharge, and observe whether there is fever, yellow urine, yellow skin, etc., and regularly go to gastroenterology and oncology departments to review liver function, serum tumor markers and CT and MRI of upper abdomen. In addition, pay attention to the diet with light and nutritious food. If there is any change of disease at home, it is important to consult and treat in time. V. Personal insight Combined with the diagnosis and treatment of this patient, for patients with persistent pain in the upper abdomen, if treatment according to gastric disease has no effect, it is necessary to further examine whether there are problems in organs other than the stomach, such as whether there is cholecystitis, gallbladder stones, pleurisy, pancreatic disease, etc. CT or MRI of the upper abdomen can be done to examine the organs around the stomach to avoid missing the diagnosis. For patients with yellow urine and yellow skin, in addition to considering whether they have hepatitis, cirrhosis and other liver diseases, they should also think about the presence of cholestatic jaundice caused by bile duct obstruction. Although the incidence of pancreatic cancer is not high, pancreatic cancer is insidious in its onset and difficult to detect in its early stages, and many patients are at advanced stages when diagnosed. Therefore, it is important to have regular medical checkups and actively seek medical attention and detailed examination when you feel unwell to avoid misdiagnosis as much as possible.