Adenomyomatous hyperplasia of the ampulla of Vater presenting as acute pancreatitis

Background: Duodenal duplication cysts (DDCs) are rare congenital anomalies typically manifesting during childhood. Clinical manifestations are uncommon in adulthood. DDCs were classically treated surgically, but endoscopic treatment has been increasingly reported. Endoscopic cyst marsupialization establishes a communication between the cyst cavity and the duodenal lumen so that the cystic content can be drained continuously into the duodenum. We herein describe two cases of symptomatic DDCs diagnosed in adulthood and submitted to endoscopic marsupialization using different techniques and devices. Case Summary: Case 1: A 23-year-old female patient was admitted with the diagnosis of acute pancreatitis. Endoscopic ultrasound revealed a 35-mm duodenal subepithelial lesion whose proximal limit was immediately distal to the ampulla of Vater and filled with fluid and calcifications. Using a duodenoscope, deroofing of the lesion was made with a diathermic snare. Pathology confirmed the diagnosis of DDC. Case 2: A 41-year-old female, submitted to laparoscopic cholecystectomy 1 month earlier due to suspected lithiasic acute pancreatitis, was admitted due to suspicion of iatrogenic biliary fistula. An endoscopic retrograde cholangiopancreatography was performed and the bile leak was treated. Immediately distal to the papillary orifice, a 20-mm subepithelial lesion was also detected. A biopsy forceps was used to fenestrate its wall, allowing the exit of mucous fluid and stones, and a sphincterotome was used to expand the incision. No recurrence was documented in both cases. Conclusion: These cases highlight DDC as a potential cause for acute pancreatitis in adults and endoscopy as an easy treatment option.

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Signet ring cell carcinoma of the ampulla of vater: a rare cause of acute pancreatitis

Scandinavian Journal of Gastroenterology ◽

10.3109/00365521.2010.525257 ◽

2010 ◽

Vol 46 (1) ◽

pp. 126-127 ◽

Cited By ~ 8

Author(s):

Adnan Taş ◽

Elif Özer ◽

Seyfettin Köklü ◽

Erdem Kocak

Keyword(s):

Acute Pancreatitis ◽

Cell Carcinoma ◽

Ampulla Of Vater ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Signet Ring ◽

Ring Cell

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Intrabiliary rupture of hepatic hydatid cyst with impacted hydatid membranes at ampulla of Vater presenting as acute pancreatitis

Tropical gastrology ◽

10.7869/tg.2012.93 ◽

2013 ◽

Vol 34 (1) ◽

pp. 43-44 ◽

Cited By ~ 2

Author(s):

Akash Chaudhary ◽

Ashok C Upadhyaya

Keyword(s):

Acute Pancreatitis ◽

Hydatid Cyst ◽

Ampulla Of Vater ◽

Hepatic Hydatid Cyst ◽

Intrabiliary Rupture ◽

Hepatic Hydatid

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Acute obstructive pancreatitis secondary to migration of a gastrostomy tube into duodenum

10.22541/au.163681677.76358822/v1 ◽

2021 ◽

Author(s):

Waka Yanagisawa ◽

Daniel Oh ◽

Dinushi Perera ◽

Sebastian Rodrigues

Keyword(s):

Acute Pancreatitis ◽

Percutaneous Endoscopic Gastrostomy ◽

Rare Complication ◽

Ampulla Of Vater ◽

Gastrostomy Tube ◽

Common Procedure ◽

Endoscopic Gastrostomy ◽

Obstructive Pancreatitis ◽

Tube Migration ◽

Peg Tube

Percutaneous endoscopic gastrostomy (PEG) tube is a common procedure. This discusses the rare complication of acute pancreatitis, due to tube migration, causing obstruction of the ampulla of Vater. Radiological confirmation of tubes prior to usage may aid in preventing this reversible complication.

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Recurrent Acute Pancreatitis Secondary to a Duodenal Duplication Cyst in an Adult. A Case Report and Literature Review

Canadian Journal of Gastroenterology ◽

10.1155/2009/979431 ◽

2009 ◽

Vol 23 (11) ◽

pp. 749-752 ◽

Cited By ~ 5

Author(s):

Nikolaos S Salemis ◽

Christos Liatsos ◽

Michail Kolios ◽

Stavros Gourgiotis

Keyword(s):

Acute Pancreatitis ◽

Healthy Adult ◽

Ampulla Of Vater ◽

Duplication Cyst ◽

Recurrent Acute Pancreatitis ◽

Cyst Excision ◽

Duodenal Duplication ◽

Infancy And Childhood ◽

Duodenal Duplication Cyst ◽

Duodenal Lumen

Duodenal duplication cysts are rare congenital abnormalities that are most commonly diagnosed in infancy and childhood. However, in rare cases, the lesion can remain asymptomatic until adulthood. An extremely rare case of a previously healthy adult patient with recurrent acute pancreatitis, who was diagnosed with a duodenal duplication cyst is presented. At laparotomy, a duplication cyst measuring 4.8 cm × 4 cm × 4 cm was found adjacent to the ampulla of Vater. A partial cyst excision and marsupialization into the duodenal lumen was performed. The patient is healthy and asymptomatic four years after surgery. The present case illustrates the necessity of considering a duodenal duplication cyst in the differential diagnosis of recurrent acute pancreatitis in previously healthy adults.

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Acute Pancreatitis Secondary to a Perivaterian Duodenal Diverticular Abscess

Case Reports in Medicine ◽

10.1155/2010/527141 ◽

2010 ◽

Vol 2010 ◽

pp. 1-3

Author(s):

P. Pastides ◽

S. Bertaud ◽

S. K. Sarker ◽

S. Dindyal

Keyword(s):

Magnetic Resonance Imaging ◽

Acute Pancreatitis ◽

Cystic Lesion ◽

Causative Factor ◽

Ampulla Of Vater ◽

Uneventful Recovery ◽

Resonance Imaging ◽

History Of ◽

The Common ◽

Head Of Pancreas

A 46-year-old previously fit lady was admitted with acute pancreatitis. She had no history of gallstones. She was not on any medications and consumed minimal amounts of alcohol. On subsequent investigations as to the causative factor, she was found at ultrasound to have an air-fluid filled cystic structure posterior to the head of pancreas which was compressing the common bile duct. Further magnetic resonance imaging and computer tomography scans showed that this cystic lesion was located around the ampulla of Vater. A diagnosis of a perivaterian abscess was made. At endoscopy, a large contained abscess was seen which was successfully drained. She made a full and uneventful recovery.

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