Problem:
You are evaluating a 60 yo female in after hours clinic for exacerbations of recurrent epigastric pain for the past 2 years. The pain is dull in character, radiates to the back, triggered by fatty foods and relieved by bending forward, with occasional associated nausea and vomiting. Upon physical exam, you noted no jaundice and hepatospleneomegaly with normoactive bowel sounds but elicited mild tenderness on palpation of the epigastrium with no guarding. Your work up revealed elevated lipase and amylase and imaging study revealed multiple hyperdense structures in the head of the pancreas and the main pancreatic duct is mildly dilated. What is the most likely diagnosis and treatment?