Abstract
A resected case of adenoma of the duodenal papilla is experienced. 59-year-old woman was seen at the hospital because of right hypochondralgia, and was diagnosed as cholelithiasis and cholecystitis by ultrasonography and blood examinations. For serum bilirubin and biliary system enzyme were slightly high, ERCP (endoscopic retrograde cholangiopancreatography) was performed. There was a tumor on the duodenal papilla and by the endoscopic biopsy the tumor turned out to be benign adenoma. Sphyntectomy, tumorectomy and insertion of T-tube were carried out. Adenomas of the duodenal papilla are rare, but recent progression in diagnostic technology increases a chance of detection. Up to July, 1991, 54 cases including this one have been reported in the Japanese literature. There adenomas are clinically benign, however, a carcinoma in adenoma can occur and sometimes we have difficulties in differential diagnosis from carcinoma. Accordingly, there are arguments over operative procedure. When surgical invasion is considered, excision of the tumor should be performed first for detailed histological examination, followed by pancreatoduodenectomy, if necessary.
