In the region of the head and neck of the pancreas are complex anatomical structures, which may be involved with a malignant process. The CT scan confirmed a mass in the region of the head of the pancreas, which invaded the descending part of the duodenum. The mass extended into the neck of the pancreas and had blocked the distal part of the bile duct and the pancreatic duct. Posteriorly the mass had directly invaded the portal venous confluence of the splenic and superior mesenteric veins, producing a series of gastric, splenic, and small bowel varices.