Intra-ampullary Adenocarcinoma Presenting as Recurrent Pancreatitis.
10.15279/kpba.2016.21.3.163
- Author:
Hyejin NOH
1
;
Hyo Jung KIM
;
Moon Kyung JOO
;
Beom Jae LEE
;
Jong Jae PARK
;
Jae Seon KIM
;
Young Tae BAK
Author Information
1. Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. hjkimmd@korea.ac.kr
- Publication Type:Case Report
- Keywords:
Idiopathic recurrent pancreatitis;
Adenocarcinoma of ampulla of vater
- MeSH:
Abdominal Pain;
Adenocarcinoma*;
Adenoma;
Ampulla of Vater;
Bile;
Biopsy;
Chemotherapy, Adjuvant;
Cholangiopancreatography, Endoscopic Retrograde;
Diagnosis;
Dilatation;
Female;
Humans;
Lymph Nodes;
Pancreatic Ducts;
Pancreaticoduodenectomy;
Pancreatitis*;
Pathology;
Pylorus;
Sphincterotomy, Endoscopic
- From:Korean Journal of Pancreas and Biliary Tract
2016;21(3):163-167
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Advances in imaging modalities have provided useful information in diagnosing ampullary lesions such as adenoma and adenocarcinoma. Endoscopic retrograde cholangiopancreaticography (ERCP) have a role in the diagnosis of unexposed intra-ampullarylesion. We report an interesting case of adenocarinoma of the ampulla of Vater presenting as idiopathic recurrent pancreatitis. A 56 years old woman was referred due to idiopathic recurrent pancreatitis for 2 years. She presented abdominal pain and upper abdominal tenderness. Magnetic resonance cholangiopancreaticography (MRCP) revealed minimal bile and pancreatic ductal dilatation without obstruction. Subsequent ERCP revealed a small polypoid lesion which was exposed after endoscopic sphincterotomy. Endoscopic biopsy showed papillary adenoma with low grade dysplasia. Additional endoscopic papillectomy was performed. Endoscopic biopsy done 3 months later showed papillary adenoma with high grade dysplasia. Pylorus preserving pancreatoduodenectomy was done and final pathology was well differentiated adenocarcinoma. The patient was recovered well but received adjuvant chemotherapy due to metastatic lymph nodes.
