1. A 35-year-old male patient resident of southern India presents with complaints of episodic severe

1. A 35-year-old male patient resident of southern India presents with complaints of episodic severe upper abdominal pain radiating to the back for the last 5 months. He has also noticed 5: TROPICAL SURGERY 41 increased thirst with polyuria and passage of bulky pale stools. He consumes tapioca as a staple diet. On examination, the abdomen is unremarkable with no palpable abnormality. His fasting blood sugar level is 180 mg/dL and plain X-ray of the abdomen shows linear calcification in the upper abdomen extending across the spine.