title: Pedunculated early carcinoma of supra-ampullary duodenum presenting as acute pancreatitis.
abstract: Background. A 43-yr-old man was admitted to our hospital after sudden onset of epigastric pain. He was diagnosed with acute pancreatitis by clinical, laboratory, and radiographic signs. Examinations for the etiology of acute pancreatitis revealed a duodenal tumor arising at the proximal portion of the descending limb, extending by a long stalk, and coming into contact with Vater's papilla. The tumor was snare-resected endoscopically. Histological examination showed an early carcinoma. Extra-ampullary carcinoma of the duodenum should be considered an unusual cause of acute pancreatitis secondary to obstruction of the major duodenal papilla. Endoscopic polypectomy is effective because of the difficulty in making a precise diagnosis by endoscopic biopsy.
authors.affiliation: Department of Internal Medicine, Suma Red Cross Hospital, Kobe 654-0121, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Fujii
authors.forename: Shinpei
authors.initials: S
authors.lastname: Tateiwa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sakai
authors.forename: Fukashi
authors.initials: F
authors.lastname: Ochi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugano
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Oshiro
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Okabayashi
mesh_terms: D000208:Acute Disease; D000328:Adult; D002277:Carcinoma / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000209:etiology* / Q000473:pathology