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A large irregular pancreatic head mass with extensive necrosis is noted. It is inseparable from the mesenteric vessels, partial thrombosis of the portal vein, dilated pancreatic duct, invades the 2nd part of the duodenum and is associated with massive pneumobilia. There is also contrast filling of the CHD and right posterior hepatic duct suggesting choledoco-duodenal fistula formation. Multiple hypodense hepatic focal lesions as metastatic deposits.