A case of carcinoma of the ampulla of Vater with cystic dilatation

Abstract

A 71-old woman, presented with jaundice, was detected dilatation of intra and extra hepatic bile duct on ultrasonography. CT revealed a tumor with contrast enhancement in the lower part of the bile duct. The finding of duodenoscope depicted swollen duodenal papilla with ulcerated mucosa and mucosal convergence. The result of biopsy specimen showed adenocarcinoma. Only suprapapillary incision enabled the deep cannulation to the bile duct. The feature of ERC showed cystic dilatation of the lower part of the bile duct without communication with pancreatic duct. EUS and IDUS revealed also supported the findings. The diagnosis carcinoma of the ampulla of Vater, developed from Ab, associated with choledochocele was made. This choledochocele had no common channel without dilated common bile duct. However, probe operation was undergone due to the multiple micro liver metastaisis.