No abstract available.
Ampulla of Vater* ; Duodenum ; Tuberculosis*

Most tumors affecting Vater's ampulla are adenocarcinomas, but a neuroendocrine carcinoma in the ampulla of Vater is extremely rare. The coexistence of these two tumors has been reported in only a few cases. Here, we report a rare case of a collision tumor of the ampulla of Vater with an adenocarcinoma and a large cell neuroendocrine carcinoma.
Adenocarcinoma ; Ampulla of Vater ; Carcinoma, Neuroendocrine

Study on 4 cases of malignant tumor of Vater’s ampulla operated at Viet-Duc Hospital and 1 case treated at University of Medicine and Pharmacy at Ho Chi Minh City between August 2003 and December 2004. Results: clinical sign is biliary obstruction jaundice. Gastroduodenoscopy with flexible tube found that papilla of Vater with the diameter lower than 3cm (histological finding: carcinomas), without metastasis to adjacent duodenum. Tumor invasion into head of pancreas and the lower of choledochous duct was determined by pancreatic and liver ultrasound, CT scanner or MRI examinations, in combination with intraoperative balance, immediate biopsy of lymph nodes in group 14 and group 8, sections of bile duct, pancreatic duct and duodenum in order to ensure the elimination of surgery. Initial outcomes showed that there wasn’t post-operative complication or death.
Ampulla of Vater ; Duodenum ; Therapeutics ; Surgery

Duodenal duplication cysts are rare congenital malformations. Most symptomatic cases are diagnosed in children and usually present with obstructive findings or bleeding symptoms. Treatment traditionally involves surgical resection, which can be often difficult because of the close proximity of the cysts to the papilla and bilopancreatic confluence. Endoscopic therapy has been used as an alternative to open surgery in a few selected cases. We report a case with a duodenal duplication cyst containing a brown pigmented stone within the cystic lumen. He was visited because of sudden right upper quadrant abdominal pain. An abdominal computed tomography revealed the presence of a cyst with a stone, which was finally removed by endoscopic resection.
Abdominal Pain ; Ampulla of Vater ; Child ; Hemorrhage ; Humans

Small cell carcinoma in the ampulla of Vater is rare, and the concurrent occurrence of adenocarcinoma and small cell carcinoma is extremely rare. We report the case of a double primary tumor, adenocarcinoma and small cell carcinoma, in the ampulla of Vater.
Adenocarcinoma ; Ampulla of Vater ; Carcinoma, Small Cell

PURPOSE: Tumors arising from the ampulla of Vater can be benign or malignant. Recently, endoscopic papillectomy has been employed in the management of benign ampulla of Vater tumors; however, surgical resection is the treatment of choice. The aim of this study was to define indications and suggest a role for transduodenal ampullectomy in the management of ampulla of Vater tumors. METHODS: We retrospectively reviewed the medical records of 54 patients treated for ampulla of Vater tumors between January 1999 and December 2008. RESULTS: Twenty-two endoscopic papillectomies and 21 transduodenal ampullectomies were performed. Four patients underwent transduodenal ampullectomy after endoscopic papillectomy due to a recurrent or remnant tumor. Recurrence or a remnant tumor was found in one patient after transduodenal ampullectomy compared to six patients after endoscopic papillectomy. Immediate intraoperative conversion from transduodenal ampullectomy to pancreaticoduodenectomy was performed in five patients based on intraoperative frozen biopsy analysis. CONCLUSION: Transduodenal ampullectomy should be performed to treat ampulla of Vater tumors that are unsuitable for endoscopic papillectomy. Transduodenal ampullectomy can serve as an intermediate treatment option between endoscopic papillectomy and pancreaticoduodenectomy in the management of ampulla of Vater tumors.
Ampulla of Vater ; Biopsy ; Humans ; Medical Records ; Pancreaticoduodenectomy ; Recurrence ; Retrospective Studies

Endoscopic retrograde cholangiopancreatography (ERCP) in post-gastrectomy patients with Billroth II (BII) reconstruction and Roux-en-Y (RY) reconstruction presents a challenge to therapeutic endoscopists. Major difficulties, including intubation to the ampulla of Vater, selective cannulation, and ampullary intervention, must be overcome in these patients. Recent data have shown that device-assisted ERCP allows for high success rates in these patients because various devices are useful for overcoming major difficulties. Therefore, good knowledge of postoperative anatomy and various devices is mandatory before performing ERCP procedures for post-gastrectomy patients.
Ampulla of Vater ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Gastrectomy* ; Gastroenterostomy ; Humans ; Intubation

Dieulafoy's lesion is a rare cause of repetitive and massive gastrointestinal bleeding, and this is characterized by an isolated arteriole protruding through a small mucosal defect. Dieulafoy's lesion is generally found in the stomach within 6 cm of the gastroesophageal junction, and usually on the lesser curvature, but many lesions have been reported in extragastric locations, including the esophagus, small bowel and rectum. A Dieulafoy's lesion in the ampulla of Vater is extremely rare, and only one such case has been reported in the Korean population. We experienced a rare case of Dieulafoy's lesion in the ampulla of Vater with massive pulsatile bleeding, and this was successfully treated by transparent cap-assisted endoscopic hemoclipping. We report here on this case with a review of the relevant literature.
Ampulla of Vater ; Arterioles ; Esophagogastric Junction ; Esophagus ; Hemorrhage ; Rectum ; Stomach

BACKGROUND/AIMS: In recent years, endoscopic snare papillectomy has been performed to treat tumors of the ampulla of Vater. This procedure requires accurate preoperative evaluation. In this study, we diagnosed the focal extension of such tumors by using endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS), and examined the indications for endoscopic snare papillectomy. METHODS: The subjects were 48 patients with a papillary tumor (13 patients, surgical resection; 35 patients, endoscopic snare papillectomy) who were evaluated preoperatively with EUS and IDUS. The tumor-node-metastasis classification was used for the endosonographic evaluation and pathological diagnosis of these tumors. RESULTS: The diagnostic accuracy of EUS was 97% for diagnosing adenomas and pTis tumors, 73% for pT1 tumors, 50% for pT2 tumors, and 50% for pT3-4 tumors, for an overall accuracy of 85% for T-staging. The diagnostic accuracy of IDUS was 94% for adenomas and pTis tumors, 73% for pT1 tumors, 50% for pT2 tumors, and 100% for pT3-4 tumors, for an overall accuracy of 80% for T-staging. CONCLUSIONS: EUS and IDUS are highly capable of evaluating tumors of the ampulla of Vater preoperatively. However, these techniques are not sufficient for evaluating the focal extension of carcinomas preoperatively. Currently, endoscopic snare papillectomy is adequate for treating adenomas and pTis tumors.
Adenoma ; Ampulla of Vater* ; Classification ; Diagnosis ; Endosonography* ; Humans ; SNARE Proteins ; Ultrasonography*

For many years ERCP has been contraindicated in acute pancreatitis. The injection of contrast medium. which may cause hyperamylasemia and occasionally an attack of acute pancreatitis even in normal indivisuals, was allowed only two to three weeks after subsidence of symptoms. Gallstone disease is one of the most common etilogical factors in pancreatitis and migration or impaction of gallstone in the ampulla of Vater causes pancreatitis. (continue...)
Ampulla of Vater ; Cholangiopancreatography, Endoscopic Retrograde* ; Gallstones ; Hyperamylasemia ; Pancreatitis*