title: Adenomyomatosis of the papilla of Vater: a case illustrating diagnostic difficulties.
abstract: OBJECTIVE
  To describe the extremely rare case of an adenomyoma of the papilla of Vater.
  
  
  METHODS
  A 42-year-old woman was hospitalized for epigastralgia and high fever. The clinical presentation and endoscopic, biochemical, and radiologic findings led to the diagnostic impression of a dysfunction of the papilla of Vater. The patient was treated successfully by laparotomy and duodenotomy, incorporating cholangiomanometry and cholangiography. Intraoperative frozen-section examination of a transduodenal papillectomy specimen led to the diagnosis of adenomyomatosis of the papilla. The patient is doing well 38 months postoperatively.
  
  
  CONCLUSIONS
  Such a combined approach to intraoperative diagnosis was important to avoid excessive surgery for a benign periampullary disease.
authors.affiliation: 2nd Department of Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kayahara
authors.forename: T
authors.initials: T
authors.lastname: Ohta
authors.forename: H
authors.initials: H
authors.lastname: Kitagawa
authors.forename: K
authors.initials: K
authors.lastname: Miwa
authors.forename: T
authors.initials: T
authors.lastname: Urabe
authors.forename: T
authors.initials: T
authors.lastname: Murata
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D014670:Ampulla of Vater; D001706:Biopsy; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003137:Common Bile Duct Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D016896:Treatment Outcome