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A rare case of periampullary carcinoma with ectopic ending of Vater's ampulla. | LitMetric

A rare case of periampullary carcinoma with ectopic ending of Vater's ampulla.

World J Gastroenterol

Department of Hepato-Bilio-Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

Published: October 2009

AI Article Synopsis

  • A 71-year-old woman experienced painless jaundice for three months, leading to imaging studies that revealed an abnormal location of the hepatopancreatic ampulla and a mass near the duodenojejunal flexure.
  • Surgery confirmed the presence of a 6 cm tumor next to the ampulla, which was successfully removed along with surrounding tissue, followed by a specific type of surgical connection to the jejunum.
  • The pathological findings showed an intestinal villous adenoma with severe abnormal cell changes, highlighting the rarity of this condition and the usefulness of MRCP in identifying biliary tract anomalies.

Article Abstract

A 71-year-old woman was referred to our department complaining of painless progressive jaundice for the last 3 mo. Magnetic resonance imaging and magnetic resonance cholangiopancreatography (MRCP) showed the ectopic hepatopancreatic ampulla draining into the fourth part of the duodenum adjacent to the duodenojejunal flexure; the irregular morphology of the duodenojejunal flexure likely due to a soft tissue mass. Laparotomy confirmed the presence of the abnormal ampulla of Vater located at the fourth part of the duodenum and a soft tissue tumor about 6 cm x 5 cm x 5 cm with a peduncle adjoining the ampulla. Resection of the tumor, including some peripheral tissue, and a Roux-Y loop anastomosis choledochojejunostomy were performed. Pathological examination indicated an intestinal villous adenoma accompanied by severe dysplasia and focal canceration. Periampullary carcinoma with ectopic ending of the Vater's ampulla into the fourth part of the duodenum is rather rare. The embryonic genetic background of this anomaly has not yet been fully explained. It is worth mentioning that MRCP is useful for demonstrating anomalies and anatomic variants of the biliary tract system and pancreatic duct.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754523PMC
http://dx.doi.org/10.3748/wjg.15.4729DOI Listing

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