Korean J Hepatobiliary Pancreat Surg.  2004 Dec;8(4):271-274.

An Adenoma of Ampulla of Vater Presented with Intussusception

• Min SI
• Kim SW
• Jang JY
• Yoon YS
• Choi MG
• Han HS
• Park YH

Abstract

Benign villous adenomas of the Ampulla of Vater are rare tumors, and the usual mode of presentation is non-specific pain, jaundice or occult bleeding. Obstruction and pancreatitis are infrequent clinical presentations, and intussusceptive symptoms secondary to an ampullary tumor of any histological type are still rarer. We describe here a case of intussusception of a villous adenoma. She presented with chronic, intermittent abdominal pain in the right upper quadrant. The radiological and endoscopic findings were considered to be due to a polypoid ampullary tumor. Upon laparotomy, the intra-duodenal mass had prolapsed beyond the 4th duodenal portion. The mass was milked back into the 2nd duodenal portion and ampullectomy with double sphincteroplasty was performed. Histology examination showed a villotubular adenoma with high grade dysplasia. The resection margins were clear of tumor.

Keyword

Adenoma; Ampulla of Vater; Intussusception

MeSH Terms

Abdominal Pain
Adenoma*
Adenoma, Villous
Ampulla of Vater*
Hemorrhage
Intussusception*
Jaundice
Laparotomy
Milk
Pancreatitis