Diagnosis and management of adenocarcinoma of the ampulla of Vater during pregnancy.
BACKGROUND
Cancer of the biliary tract has a poor prognosis and its association with pregnancy is uncommon. Early diagnosis allowing curative surgical resection offers the only hope of long-term survival.


METHODS
This report describes the case of a young 26-week-pregnant woman admitted for cholestatis documented by clinical and laboratory examination. Ultrasonography (US) and magnetic resonance cholangiopancreatography (MRCP) were indicative of common bile tract obstruction. Caesarian section was performed at 32 weeks of pregnancy and the tumor was promptly biopsied. Histology demonstrated carcinoma of the ampulla of Vater. The patient underwent a Whipple procedure. Both mother and baby survived.


CONCLUSIONS
Pregnant patients with digestive cancer require careful management. Acute non-invasive assessment and radical surgery improve outcome for both the mother and fetus.
Haddad
O
O
Department of Digestive Surgery, Service Pr Gamerre, Hospital La Conception, 147 Boulevard Baille, 13385 Marseille Cedex, France.
Porcu-Buisson
G
G
Sakr
R
R
Guidicelli
B
B
Letreut
Y P
YP
Gamerre
M
M
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D014670:Ampulla of Vater; D001706:Biopsy; D002585:Cesarean Section; D049448:Cholangiopancreatography, Magnetic Resonance; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005865:Gestational Age; D006801:Humans; D008197:Lymph Node Excision; D016577:Pancreaticoduodenectomy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography