Abstract
A 71-year-old woman diagnosed with obstructive jaundice associated with common bile duct stones was referred to our hospital. ERCP revealed hemobilia and distal bile duct stenosis, but biliary cytology and examination of biopsy specimens revealed no malignant cells. As cholangiocarcinoma could not be ruled out, a pylorus-preserving pancreatoduodenectomy was performed. No histopathological evidence of malignancy was revealed, while adenomyomatous hyperplasia was observed in the ampullary bile duct. AA type amyloid deposits and vasculitis were found within the vascular walls of the pancreatic head, gall bladder, and extrahepatic duct. We concluded that the hemobilia was associated with amyloidosis secondary to rheumatoid arthritis.
