CASE REPORTS

Isolated Ampullary Adenoma Causing Biliary Obstruction

download Full Article (PDF file)

Salvatore Greco¹, Andrea Cassinotti¹, Alessandro Massari¹, Ilaria Bossi², Emilio Trabucchi³, Gabriele Bianchi Porro¹

1) Department of Clinical Sciences, Gastroenterology Unit;
2) Department of Internal Medicine;
3) Unit of Surgery, L. Sacco University Hospital, Milano, Italy

Abstract

This is an interesting case of an isolated ampullary adenoma causing biliary obstruction that required surgical excision. We describe a patient who presented with a six month history of recurrent attacks of typical biliary pain radiating from the right upper quadrant of the abdomen to the back, nausea and vomiting, which we attributed to a large pedunculated tubulovillous adenoma. Abdominal ultrasound and endoscopic ultrasonography provided useful information in the diagnostic assessment of ampullary adenoma. Sporadic duodenal adenomas are an increasingly recognized condition in those with familial adenomatous polyposis syndromes as well as sporadic cases.

Keywords
Sporadic duodenal adenoma intestinal ultrasound - endoscopic ultrasonography (EUS) - radical surgery.