A 55-year-old patient, recently diagnosed with a pancreatic head neoplasm (ductal adenocarcinoma) with peritoneal metastases, presented to the Emergency Department with melena and recent-onset jaundice. One month prior, the patient had sought care at another facility for upper gastrointestinal bleeding secondary to a gastric ulcer, which was histopathologically confirmed as a consequence of adjacent tumor invasion. At that time, a definitive diagnosis of the pancreatic lesion was established via EUS with fine-needle biopsy. The echoendoscope could not be advanced into the duodenum due to a likely tumor-induced duodenal stricture.