A Report Of A Rare Case Of Bronchogenic Adenocarcinoma With Metastasis To The Ampulla Of Vater Causing Obstructive Jaundice

ABSTRACT Gallstones may pass into the gastrointestinal tract spontaneously through the ampulla of Vater or through a biliary-enteric fistula. This report describes an extremely rare case of a patient vomiting a gallstone without the presence of a fistula between the gallbladder and the gastrointestinal tract. Furthermore, no imaging findings of gallstones disease appeared. The patient has been treated conservatively and all symptoms subsided. The patient remains asymptomatic 3 months after treatment and an elective laparoscopic cholecystectomy was arranged. Including this reported case, only three cases have been described in the literature worldwide. However, our case is the only one characterized by retrograde flow of the gallstones into the stomach without symptoms of bowel obstruction or other underlying pathologies.

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Mucin-filled CBD, difficult to manage cholangitis

BMJ Case Reports ◽

10.1136/bcr-2020-238363 ◽

2021 ◽

Vol 14 (1) ◽

pp. e238363

Author(s):

Manish Kumar ◽

Ujjwal Sonika ◽

Sanjeev Sachdeva ◽

Ashok Dalal

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Obstructive Jaundice ◽

Rare Case ◽

Malignant Potential ◽

Cystic Neoplasm ◽

Stricture Formation ◽

Intraductal Papillary Mucinous Neoplasms ◽

Mucinous Neoplasms ◽

Optimum Management

Intraductal papillary mucinous neoplasms (IPMNs) are mucin-secreting cystic neoplasm of pancreas. They have a malignant potential. They are usually localised to the pancreas but occasionally can involve surrounding structures (1.9%–6.6%), like bile duct and duodenum, and are labelled as IPMN with invasion. Jaundice as a manifestation of IPMN is not common (4.5%). It can present as jaundice as a result of invasion of common bile duct (CBD) resulting in stricture formation or uncommonly as a result of fistulising to CBD with resultant obstruction of CBD by thick mucin secreted by this tumour. As only few cases (around 23) of mucin-filled CBD are reported in the literature. We are presenting our experience in dealing a rare case of obstructive jaundice caused by IPMN fistulising into CBD, highlighting the difficulties faced in managing such case, especially with regards to biliary drainage and what can be the optimum management in such cases.

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Gallbladder Ascariasis : A Rare Case Report

Med Phoenix ◽

10.3126/medphoenix.v3i1.20770 ◽

2018 ◽

Vol 3 (1) ◽

pp. 95-97 ◽

Cited By ~ 1

Author(s):

Akhilesh Kumar Jha ◽

Rajesh Acharya ◽

Kamal Subedi ◽

Anuj Shrestha ◽

Krishna Rauniyar ◽

...

Keyword(s):

Case Report ◽

Bile Duct ◽

Common Bile Duct ◽

Ascaris Lumbricoides ◽

Rare Case ◽

Ampulla Of Vater ◽

Human Beings ◽

Helminthic Infection ◽

Rare Case Report

Ascariasis is the most prevalent helminthic infection to infest human beings caused by Ascaris lumbricoides. Rarely the worm migrates through ampulla of Vater and may enter common bile duct. This is a case report of live Ascaris lumbricodes in gallbladder, on USG. Med Phoenix. Vol. 3, Issue. 1, 2018, Page: 95-97

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