title: Hereditary hemorrhagic telangiectasis involving the ampulla of Vater presented with recurrent gastrointestinal bleeding.
abstract: We report a Chinese lady with hereditary hemorrhagic telangiectasia who presented with multiple episodes of gastrointestinal bleeding requiring transfusion. Gastroscopy, colonoscopy, isotope-labeled red blood cell scan, and selective arteriography were performed, but could not locate the source of bleeding. A bleeding lesion in the ampulla of Vater was seen when endoscopic retrograde cholangiopancreatography was attempted. She had an uneventful pylorus-preserving Whipple's operation with no further evidence of gastrointestinal bleeding. This is the first case report to show that the vascular ectasia of patients with hereditary hemorrhagic telangiectasia could manifest at the ampulla of Vater.
authors.affiliation: Department of Surgery, University of Hong Kong, Queen Mary Hospital.
authors.forename: K M
authors.initials: KM
authors.lastname: Chu
authors.forename: E C
authors.initials: EC
authors.lastname: Lai
authors.forename: I O
authors.initials: IO
authors.lastname: Ng
mesh_terms: D014670:Ampulla of Vater / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003137:Common Bile Duct Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology