Ampullary Adenocarcinoma Presenting with Acute Pancreatitis

Abstract

A 59-year-old man was admitted because of acute pancreatitis. Esophagogastroduodenoscopy revealed an ampullary tumor which was diagnosed as tubular adenoma by biopsy. Because it was very difficult to detect carcinoma in adenoma and measure invasion depth, pylorus-preserving pancreaticoduodenectomy was performed after improvement in pancreatitis symptoms. Pathological findings revealed a growth in carcinoma tissue within the common channel and main pancreatic duct, which might be the cause of pancreatitis. The accessory duct of Santorini could not be detected with MRCP or pathological findings. Carcinoma tissue is limited at the mucosa (Tis, stage I). Although ampullary tumor is usually diagnosed by the presence of jaundice, acute pancreatitis is a rare feature. We review previous case reports on ampullary tumor presenting with acute pancreatitis.