Recurrent acute pancreatitis caused by ampullary villous adenoma.
Neoplastic lesions of the ampulla of Vater are a rare cause of acute and recurrent pancreatitis. We have recently had the privilege of studying a 58-year-old woman who presented with recurrent pancreatitis. At endoscopic retrograde pancreatography, a mucosal abnormality of the ampulla of Vater was noted and documented to be a villous adenoma. It was resected surgically and the patient has been symptom free. This report documents the ninth patient in the English literature with pancreatitis secondary to a benign neoplasm of the ampulla of Vater. Six of the nine patients have been male. They have ranged in age from 42 to 68 years. Approximately 30% of villous adenomas of the duodenum contain foci of invasive or in situ carcinoma. Villous adenomas of the ampulla of Vater require aggressive therapy. Further, it has been noted that a number of patients with small intestinal neoplasms have concomitant large-bowel polyps.
Guzzardo
G
G
University of Rochester, School of Medicine and Dentistry, Strong Memorial Hospital, Department of Medicine, New York.
Kleinman
M S
MS
Krackov
J H
JH
Schwartz
S I
SI
D000208:Acute Disease; D000236:Adenoma / Q000150:complications*; D014670:Ampulla of Vater / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology*; D012008:Recurrence