title: Adenoma of the ampulla of Vater: a case report.
abstract: BACKGROUND
  Lesions of the ampulla of Vater are rare histological entities with an incidence of between 0.1 and 0.2% of gastrointestinal tumors. Until recently the main response to this kind of lesion was duodenopancreatectomy, regardless of the cellular atypia and local edema. In this study, we propose the application of transduodenal local excision of the ampulla of Vater especially in recognized cases of nonmalignant adenomas.
  
  
  METHODS
  In this case report we analyze the case of a 78-year-old Greek man who revealed symptoms such as icterus, abdominal pain without constipation and bloody stools. A physical examination showed painless swelling of the gallbladder (Courvoisier sign). No previous abdominal operations or hernias were identified. Blood tests, computed tomography scan analysis, gastroscopy and endoscopic retrograde cholangiopancreatography along with biopsies and cytological tests diagnosed nonmalignant adenoma of the ampulla of Vater with high-grade dysplasia. The treatment we followed was transduodenal local excision of his ampulla of Vater.
  
  
  CONCLUSIONS
  Transduodenal local excision of the ampulla of Vater has limited side effects and postoperative complications, suggesting this particular technique to be the proper treatment for nonmalignant cases of adenomas.
authors: Konstantinos
authors: K
authors: Alexiou
authors: Department of Surgery, Sismanoglion General Hospital, Sismanoglou 1, P,O, Box 15126, Athens, Greece. argioannid@med.uoa.gr.
authors: Argyrios
authors: A
authors: Ioannidis
authors: Ioannis
authors: I
authors: Drikos
authors: Athanasios
authors: A
authors: Fotopoulos
authors: Ioannis
authors: I
authors: Karanikas
authors: Nikolaos
authors: N
authors: Economou
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D014670:Ampulla of Vater / Q000000981:diagnostic imaging / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016145:Endoscopy, Digestive System / Q000379:methods; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed