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Pancreatitis and renal infarction on CT scan of abdomen/pelvis with IV contrast Computed Tomography (CT) showing severe left hydronephrosis without discrete ureteral calculus. There is also left renal cortical hypo-enhancement, which is suggestive of pyelonephritis and acute pancreatitis (vertical red arrow) but no pancreatic necrosis or peri-pancreatic fluid. Bilateral kidneys were significant for renal infarctions (horizontal arrow).

Pancreatitis and renal infarction on CT scan of abdomen/pelvis with IV contrast Computed Tomography (CT) showing severe left hydronephrosis without discrete ureteral calculus. There is also left renal cortical hypo-enhancement, which is suggestive of pyelonephritis and acute pancreatitis (vertical red arrow) but no pancreatic necrosis or peri-pancreatic fluid. Bilateral kidneys were significant for renal infarctions (horizontal arrow).

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This case illustrates that although advances have been made with diagnosis and treatment of adenocarcinoma of unknown origin with targeted therapy, more research needs to be done on poorly differentiated adenocarcinoma that initially presents with extensive metastases. In this patient's case, it was beneficial and ethical to reduce the toxicity and...

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... ultrasound (US) demonstrated several deep vein thrombosis (DVT) in all four extremities. Repeat CT scan of the abdomen and pelvis showed pancreatitis and wedge-shaped hypodensities in the spleen and kidneys concerning for infarction ( Figure 1). An echocardiogram revealed a 0.9 cm x 0.6 cm mass in the atrial side of the posterior mitral leaflet. ...

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