title: Pancreaticoduodenectomy as treatment of adenocarcinoma of the papilla of Vater diagnosed during pregnancy. A case report.
abstract: BACKGROUND
  Papillary adenocarcinomas are rare tumors of the gastrointestinal tract. There are few reports of this neoplasm diagnosed during pregnancy.
  
  
  METHODS
  A case of adenocarcinoma of the papilla of Vater was diagnosed by sonographically guided biopsy during pregnancy. The patient underwent radical resection of the tumor at 25 weeks' gestation; pregnancy termination was not indicated. At 39 weeks' gestation, a cesarean-section was performed. The postoperative period entailed total parenteral nutrition until intestinal motility stabilized. This ensured the mother and fetus' well-being until delivery.
  
  
  CONCLUSIONS
  Papillary adenocarcinoma is associated with good prognosis since it is totally removed by radical resection, and pancreaticoduodenectomy can be performed successfully during pregnancy, but the patient must receive special prenatal care.
authors.affiliation: Departments of Obstetric and Gynecology, University of São Paulo Medical School, São Paulo, Brazil. rodrigoruano@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Ruano
authors.forename: E A
authors.initials: EA
authors.lastname: Hase
authors.forename: C
authors.initials: C
authors.lastname: Bernini
authors.forename: D S
authors.initials: DS
authors.lastname: Steinman
authors.forename: D
authors.initials: D
authors.lastname: Birolini
authors.forename: M
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D014670:Ampulla of Vater / Q000000981:diagnostic imaging / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D016577:Pancreaticoduodenectomy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging / Q000601:surgery*; D016216:Ultrasonography, Prenatal