A 45-year-old man with alcoholism is admitted to the hospital for acute pancreatitis. He initially responds well to bed rest and intravenous fluid, but 1 week later he has persistent fever and epigastric pain. His temperature is 38.6°C (101.5°F). Abdominal examination shows a tender epigastric mass. Laboratory studies show a leukocyte count of 13,500/mm3 and serum amylase activity of 300 U/L. Which of the following is the most likely cause of these findings? A) Acute gastric dilatation B) Carcinoma of the stomach C) Chronic pancreatitis D) Cystic adenocarcinoma of the pancreas E) Pancreatic pseudocyst F) Perforated gastric ulcer with abscess
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