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A 53−year−old woman presented with a history of abdominal pain, nausea, vomit− ing, and a 40−kg weight loss, without change in bowel pattern. Physical exami− nation revealed epigastric tenderness, good bowel sounds, and an abdominal fluid wave. Rectal examination was nor− mal without occult blood. Abdominal computed tomography (CT) scan revealed a hypodense area of enlargement in the head of the pancreas, ascites, and multi− ple metastatic lesions in the liver, and normal bowels.

Endoscopic ultrasound diagnosis of colon cancer metastatic to the pancreas