A 62-year-old man is admitted with abdominal pain and weight loss of 5 lb over the past month. He has continued to consume large amounts of rum. Examination reveals icteric sclera. The indirect bilirubin level is 5.6 mg/dL with a total bilirubin of 6 mg/dL. An ultrasound shows a 4-cm pseudocyst. What is the most likely cause of jaundice in a patient with alcoholic pancreatitis?
High-Yield Explanation
A recent increase in alcohol consumption explains the jaundice secondary to alcoholic hepatitis in the majority of such patients. Carcinoma of the pancreas is relatively rare but often causes difficulty in the differentiation from pancreatitis. A pseudocyst measuring 4 cm is not likely to be associated with nonobstructive jaundice in this patient.