Spondyloarthropathy after ampullary carcinoma resection: "post-Whipple" disease.
The development of bowel-bypass syndrome complicating the Whipple procedure for biliary tract carcinoma is described here for the first time. A 56-year-old HLA-B27 + man, treated with excision of adenocarcinoma of the ampulla of Vater, developed an undifferentiated spondyloarthropathy, initially unresponsive to nonsteroidal anti-inflammatory drugs and doxycycline, but eventually controlled with sulfasalazine and tapered corticosteroids. This condition represents another example of a rheumatic syndrome occurring after disruption of gastrointestinal tract continuity and likely development of small bowel bacterial overgrowth.
Bhangle
Samir D
SD
Department of Medicine, Saint Barnabas Medical Center, Livingston, New Jersey, USA.
Kramer
Neil
N
Rosenstein
Elliot D
ED
D000230:Adenocarcinoma / Q000601:surgery*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004386:Duodenum / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D025242:Spondylarthropathies / Q000188:drug therapy / Q000209:etiology*
D000305:Adrenal Cortex Hormones