1.Necessity of Histologic Confirmation for Adequate Management in Ampullary Tumors.
The Korean Journal of Gastroenterology 2013;62(6):315-316
No abstract available.
Adenomyoma/*pathology
;
Ampulla of Vater/*pathology
;
Common Bile Duct Neoplasms/*pathology
;
Female
;
Humans
;
Male
2.Necessity of Histologic Confirmation for Adequate Management in Ampullary Tumors.
The Korean Journal of Gastroenterology 2013;62(6):315-316
No abstract available.
Adenomyoma/*pathology
;
Ampulla of Vater/*pathology
;
Common Bile Duct Neoplasms/*pathology
;
Female
;
Humans
;
Male
3.Malignant Gastrointestinal Stromal Tumor of the Ampulla of Vater: A Case Report.
Su Ho KIM ; Jong Hyeok KIM ; Gwang Ho BAIK ; Ilhyun BAEK ; Taeho HAHN ; Soon Ok OH ; Jin Bong KIM ; Sang Hoon PARK ; Woong Ki CHANG ; Dong Joon KIM ; Choong Kee PARK ; Hye Rim PARK
The Korean Journal of Gastroenterology 2004;43(1):66-70
GIST is a rare neoplasm, the majority of GISTs are located in the stomach and small intestine. Most GISTs are diagnosed histopathologically after resection because of submucosal location. A 37-year-old female patient presented with a 2-weeks history of generalized weakness, nausea accompanied by intermittent passage of black, tarry stools. Esophagogastroduodenoscopy and ERCP showed a large round mass measuring 5 cm in diameter in the ampulla of Vater with ulcer crack. Endoscopic multiple biopsies from the mass including ulcer base were taken. Light microscopic findings showed spindle-shaped and epitheloid tumor cells having high cellularity and frequent mitotic figures. On immunohistochemical stainings, the tumor cells were positive for CD34 and smooth muscle actin. Based on these preoperative findings, a diagnosis of malignant GIST of the ampulla of Vater was made probably. After operation, immunohistochemical studies revealed positive reaction for c-kit and vimentin, as well as focally reactive for CD34 and smooth muscle actin. We report a case of GIST in the ampulla of Vater presenting with melena that was diagnosed preoperatively and postoperatively.
Adult
;
*Ampulla of Vater
;
Common Bile Duct Neoplasms/*diagnosis/pathology
;
Female
;
Gastrointestinal Stromal Tumors/*diagnosis/pathology
;
Humans
5.Obstructive jaundice and acute cholangitis due to papillary stenosis.
Jun Pyo CHUNG ; Jun Sik CHO ; Young Nyun PARK ; Se Joon LEE ; Kwan Sik LEE ; Jae Bock CHUNG ; Sang In LEE ; Jin Kyung KANG ; Ki Whang KIM ; Hoon Sang CHI
Yonsei Medical Journal 1999;40(2):191-194
Papillary stenosis is characterized by fixed fibrosis leading to structural outflow obstruction and it is usually secondary to inflammation and fibrosis from the chronic passage of gallstones, episodes of acute pancreatitis, chronic pancreatitis, sclerosing cholangitis, peptic ulcer disease, and cholesterolosis. However, obstructive jaundice with or without acute cholangitis which leads the physician to suspect the presence of malignancy as a cause is a rare manifestation of papillary stenosis. We report here a case of papillary stenosis presenting with obstructive jaundice and acute cholangitis. The lesion was so difficult to exclude the presence of malignancy preoperatively and intraoperatively that a pylorus-preserving pancreaticoduodenectomy was performed. Histologic examination of the resected specimen revealed fibrosis, adenomatoid ductal hyperplasia, and mild chronic inflammation of the papilla of Vater and distal common bile duct.
Acute Disease
;
Case Report
;
Cholangitis/etiology*
;
Cholestasis/etiology*
;
Cholestasis/complications*
;
Common Bile Duct Diseases/complications*
;
Human
;
Male
;
Middle Age
;
Vater's Ampulla*/radiography
;
Vater's Ampulla*/pathology
6.Thre Cases of Mucinous Ductal Ectasia of the Pancreas Which Were Diagnosed by Duodenoscopic Findings.
Young Il MIN ; Sung Koo LEE ; Myung Hwan KIM ; Il Han SONG ; Ho Soon CHOI ; Me Ran YU ; Me Hwa LEE ; Sun Mee PARK ; Dong Jin SUH ; Kyung Yub GONG ; Eun Sil YU ; Moon Gyu LEE ; Duck Jong HAN
Korean Journal of Gastrointestinal Endoscopy 1995;15(2):279-284
We have experienced three cases of mucinous ductal ectasia of the pancreas. They showed the characteristic duodenoscopic findings and underlying pathology was hyperplasia in two cases and adenocarcinoma in one case. When endoscopic retrograde pancreatography was performed, bulging ampulla of Vater, patulous ampullary orifice and mucus leakage from papillary orifice were noted. Also cyst-like dilatation of main duct or side branch of the uncinate process were observed.
Adenocarcinoma
;
Ampulla of Vater
;
Dilatation
;
Dilatation, Pathologic*
;
Hyperplasia
;
Mucins*
;
Mucus
;
Pancreas*
;
Pathology
7.Congenital Duodenal Web Associated with a Foreign Body (Go Stone) in a 10-Year-Old Girl.
Woo Hyun PARK ; Soon Ok CHOI ; Jin Bok HWANG
Journal of the Korean Association of Pediatric Surgeons 2005;11(2):171-174
Chronic duodenal obstruction related to a congenital web is a rare anomaly that is sometimes difficult to diagnose preoperatively. A case of partial duodenal obstruction along with a foreign body by a congenital duodenal web in a 10-year- old girl is presented. She has had one year history of intermittent epigastric discomfort without nausea, vomiting and growth retardation. The studies including UGI series and gastroduodenoscopy disclosed a perforated web in the 2nd portion of the duodenum and a dark go stone just proximal to the web. Via a longitudinal duodenotomy across the web, the web was partly excised with preservation of ampulla of Vater and the duodenum was closed in transverse fashion. The aperture of ampulla of Vater was located at 7 o'clock direction of posterior surface of the duodenal web. This particular case reminds clinicians to consider a duodenal web in a youngster presenting with a longstanding foreign body in the duodenum as one of the underlying pathologies.
Adolescent
;
Ampulla of Vater
;
Child*
;
Duodenal Obstruction
;
Duodenum
;
Female*
;
Foreign Bodies*
;
Humans
;
Nausea
;
Pathology
;
Vomiting
8.Current Status of Endoscopic Papillectomy for Ampullary Tumors.
Jong Ho MOON ; Hyun Jong CHOI ; Yun Nah LEE
Gut and Liver 2014;8(6):598-604
Detection of tumors of the ampulla of Vater, including ampullary adenoma, has been improved by routine screening endoscopic procedures and imaging modalities. Endoscopic resection by endoscopic papillectomy is rapidly replacing classic surgical resection and is a less invasive procedure. Endoscopic resection can have a role not only in the final histopathologic diagnosis but also as a definite therapeutic option. However, the indications for endoscopic resection are not fully established, and endoscopic procedures are not standardized. Significant complications, including severe pancreatitis, intractable bleeding and duodenal perforation, are rare but can occur, especially in less experienced hands. Severe pancreatitis is the most feared complication, but it can be prevented by pancreatic duct stent insertion in most cases. However, in some cases, pancreatic stenting can be challenging after resection. Incomplete resections are sometimes performed to avoid complications. Endoscopic surveillance is also important for identifying and managing remnant adenomatous tissue or recurrent lesions. Further technical development is needed to expand the indications for this procedure, minimize complications and ensure a high success rate.
Adenoma/pathology/*surgery
;
Ampulla of Vater/pathology/*surgery
;
Carcinoma/pathology/*surgery
;
Common Bile Duct Neoplasms/pathology/*surgery
;
Endoscopy, Digestive System
;
Humans
9.Acral Metastasis in a Patient with Ampullary Carcinoma.
Eun Young CHO ; Tae Hyeon KIM ; Seok Don PARK ; Ki Jung YUN ; Suck Chei CHOI ; Haak Cheoul KIM ; Yong Ho NAH
The Korean Journal of Internal Medicine 2007;22(1):55-58
Although skin metastasis from a malignant tumor of an internal organ usually occurs at an advanced disease stage, there has been no prior report of a cutaneous acral metastasis from ampullary carcinoma to date. We report a 71-year old male patient with cutaneous metastasis from an ampullary adenocarcinoma. The patient had a history of pylorus preserving pancreaticoduodenectomy for carcinoma of the ampulla of Vater two years prior to presentation. Physical examination revealed ill-defined, painful and hard erythematous nodules at the left thumb and distal phalanx of the right middle finger. The computed tomography scan showed low density masses in the retroperitoneum; the histological examination of a nodule from the right middle finger showed a metastatic adenocarcinoma. This case illustrates that cutaneous metastasis from ampullary carcinoma has a poor prognosis.
Skin Neoplasms/*secondary
;
Prognosis
;
Male
;
Humans
;
Fatal Outcome
;
Common Bile Duct Neoplasms/*pathology
;
Ampulla of Vater/*pathology
;
Aged
;
Adenocarcinoma/*pathology
10.A Case of Adenosquamous Carcinoma of the Papilla of Vater.
Hae Geun SONG ; Kyo Sang YOO ; Na Rae JU ; Jin Chul PARK ; Jae One JUNG ; Woon Geon SHIN ; Joon Ho MOON ; Jong Pyo KIM ; Kyoung Oh KIM ; Cheol Hee PARK ; Taeho HAHN ; Sang Hoon PARK ; Jong Hyeok KIM ; In Jae LEE ; Soo Kee MIN ; Choong Kee PARK
The Korean Journal of Gastroenterology 2006;48(2):132-136
Adenosquamous carcinoma of the papilla of Vater is a rare tumor and only a few cases have been reported so far. Here, we report a case of adenosquamous carcinoma in a 76-year-old male who presented with jaundice and right upper quadrant abdominal pain. Ultrasonography and enhanced abdominal CT scans showed dilated common bile duct (CBD) and intrahepatic bile duct (IHD) with a suspicious obstructing mass in distal CBD. On endoscopy, obstructing and ulcerated mass was noted on the papilla of Vater. Histopathological inspection of the biopsied specimens from mass showed adenosquamous cell carcinoma of the papilla of Vater. Since the patient refused operation, we inserted a self-expandable metallic stent in distal CBD. This is the first case report on adenosquamous carcinoma of the papilla of Vater in Korea.
Aged
;
Ampulla of Vater/*pathology
;
Carcinoma, Adenosquamous/*diagnosis/pathology/surgery
;
Cell Differentiation
;
Humans
;
Immunohistochemistry
;
Male
;
Tomography, X-Ray Computed