Male, over 50 years old, came to the clinic with abdominal distension and epigastric discomfort for 1 month. Gastroscopy suggested gastritis and Helicobacter pylori was positive, but systematic debacterization treatment did not improve, and then pancreatic cancer was diagnosed by pancreatic enhancement CT examination. Pancreatic cancer has no obvious symptoms in early stage, and the main symptom of most patients is epigastric discomfort. Some patients may have symptoms of indigestion such as abdominal distension, loss of appetite, diarrhea, etc., which is easy to be misdiagnosed as gastric disease, and it means that the tumor has reached the middle or late stage when there is severe abdominal pain and jaundice, so we remind patients and clinicians to be alert to pancreatic disease when the treatment effect is poor according to gastritis, especially when accompanied by low back pain. Patients with epigastric pain should at least have a pancreatic ultrasound and, if necessary, a pancreatic CT examination to avoid misdiagnosis and underdiagnosis.