Obstructive jaundice and acute cholangitis due to papillary stenosis.
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3349/ymj.1999.40.2.191
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Jun Pyo CHUNG
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		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
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. chungjp@yumc.yonsei.ac.kr
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Case Report
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Papillary stenosis;
			        		
			        		
			        		
				        		obstructive jaundice;
			        		
			        		
			        		
				        		pancreaticoduodenectomy
			        		
			        		
	        			
        			
        		
 
        	
            
            	- MeSH:
            	
	        			
	        				
	        				
				        		
					        		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
				        		
			        		
	        			
	        			
            	
            	
 
            
            
            	- From:Yonsei Medical Journal
	            		
	            		 1999;40(2):191-194
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	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.