A 58-year-old man with a 30-year history of alcoholism and pancreatitis is admitted to the hospital with an elevated bilirubin level of 5 mg/dL, acholic stools, and an amylase level of 600 U. Obstructive jaundice in chronic pancreatitis usually results from which of the following?

Fibrosis in the head of the pancreas as a result of chronic inflammation may lead to compression of the CBD. In pancreatitis, the narrowing of the CBD is smooth on x-ray studies. There is no association with pancreatitis and sclerosing cholangitis. Alcoholic hepatitis is the most common cause of jaundice, but it most frequently is not of an obstructive nature. Pseudocysts and carcinoma of the head of the pancreas are other recognized causes of obstructive jaundice in patients with chronic pancreatitis.