학술논문
Adenomyomatosis of the Common Bile Duct and Ampulla of Vater
Document Type
Clinical report
Author
Source
GE- Portuguese Journal of Gastroenterology. February 1, 2021, Vol. 28 Issue 2, p121, 13 p.
Subject
Language
English
Abstract
Author(s): Catarina Gouveia (corresponding author) [a]; Catarina Fidalgo [a]; Rui Loureiro [a]; Helena Oliveira [b]; Rui Maio [c]; Marília Cravo [a] Introduction Adenomyomatosis (adenomyomatous hyperplasia, adenomyosis, or adenomyoma) is a [...]
Adenomyomatosis is a rare benign lesion that has been observed in different sites throughout the gastrointestinal tract, most frequently in the gallbladder. Few cases have been described in the stomach, small bowel, bile ducts, and ampullary region. Adenomyomas of the vaterian system (ampulla and common bile duct) have important clinical consequences, since the majority of these lesions present with biliary tract obstruction and mimic malignant behavior. As a consequence, considering the diagnostic difficulty of these lesions, patients are often treated with extensive surgery (pancreaticoduodenectomy). We report 2 cases of adenomyomatosis: one of the ampulla of Vater and the other of the common bile duct, as well as a review of reported cases in the literature. Both of our patients presented with epigastralgia and had laboratory or endoscopic evidence of biliary obstruction. Both patients underwent endoscopic ultrasound, one of them with fine-needle aspiration; however, it was not possible to exclude the possibility of cancer. The diagnosis of adenomyoma was only confirmed by the surgical specimen after pancreaticoduodenectomy. Keywords: Adenomyomatous hyperplasia, Adenomyosis, Adenomyomatosis, Adenomyoma, Ampulla of Vater, Common bile duct
Adenomyomatosis is a rare benign lesion that has been observed in different sites throughout the gastrointestinal tract, most frequently in the gallbladder. Few cases have been described in the stomach, small bowel, bile ducts, and ampullary region. Adenomyomas of the vaterian system (ampulla and common bile duct) have important clinical consequences, since the majority of these lesions present with biliary tract obstruction and mimic malignant behavior. As a consequence, considering the diagnostic difficulty of these lesions, patients are often treated with extensive surgery (pancreaticoduodenectomy). We report 2 cases of adenomyomatosis: one of the ampulla of Vater and the other of the common bile duct, as well as a review of reported cases in the literature. Both of our patients presented with epigastralgia and had laboratory or endoscopic evidence of biliary obstruction. Both patients underwent endoscopic ultrasound, one of them with fine-needle aspiration; however, it was not possible to exclude the possibility of cancer. The diagnosis of adenomyoma was only confirmed by the surgical specimen after pancreaticoduodenectomy. Keywords: Adenomyomatous hyperplasia, Adenomyosis, Adenomyomatosis, Adenomyoma, Ampulla of Vater, Common bile duct