title: Amiodarone hepatotoxicity complicating obstructive jaundice due to ampullary cancer.
abstract: BACKGROUND
  The presence of dual pathology can cause diagnostic dilemmas. We present a case of adenocarcinoma of the ampulla of Vater with concurrent amiodarone hepatotoxicity.
  
  
  METHODS
  Painless jaundice associated with a palpable gallbladder was investigated clinically, radiologically, endoscopically and via liver biopsy.
  
  
  RESULTS
  Liver biopsy showed amiodarone hepatotoxicity. Endoscopic biopsy identified an ampullary adenoma. However, the endoscopic ultrasound and intra-operative findings suggested a malignancy, which was confirmed postoperatively.
  
  
  CONCLUSIONS
  While the classic findings of Courvoisier's Law are borne out in this case, the etiology of jaundice is twofold. Although dual pathology is uncommon it should always be considered.
authors: Department of Surgery and Hepatology, St. Vincent's University Hospital, Dublin 4, Ireland.
authors: Anne M
authors: AM
authors: Collins
authors: Des C
authors: DC
authors: Winter
authors: Aidan P
authors: AP
authors: McCormick
authors: David C
authors: DC
authors: Cottell
authors: Justin G
authors: JG
authors: Geoghegan
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000188:drug therapy; D000368:Aged; D000638:Amiodarone / Q000633:toxicity*; D014670:Ampulla of Vater / Q000473:pathology*; D001706:Biopsy; D003138:Common Bile Duct Neoplasms / Q000150:complications* / Q000188:drug therapy; D005704:Gallbladder / Q000473:pathology; D006801:Humans; D041781:Jaundice, Obstructive / Q000150:complications / Q000209:etiology*; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D008107:Liver Diseases / Q000150:complications; D008297:Male
chemical_list: D000638:Amiodarone