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KMID : 0985520160210030163
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Korean Journal of Pancreas and Biliary Tract
2016 Volume.21 No. 3 p.163 ~ p.167
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Intra-ampullary Adenocarcinoma Presenting as Recurrent Pancreatitis
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Noh Hye-Jin
Kim Hyo-Jung
Joo Moon-Kyung
Lee Beom-Jae
Park Jong-Jae
Kim Jae-Seon
Park Young-Tae
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Abstract
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Advances in imaging modalities have provided useful information in diagnosing ampullary lesions such as adenoma and adenocarcinoma. Endoscopic retrograde cholangiopancreaticography (ERCP) have a role in the diagnosis of unexposed intra-ampullarylesion. We report an interesting case of adenocarinoma of the ampulla of Vater presenting as idiopathic recurrent pancreatitis. A 56 years old woman was referred due to idiopathic recurrent pancreatitis for 2 years. She presented abdominal pain and upper abdominal tenderness. Magnetic resonance cholangiopancreaticography (MRCP) revealed minimal bile and pancreatic ductal dilatation without obstruction. Subsequent ERCP revealed a small polypoid lesion which was exposed after endoscopic sphincterotomy. Endoscopic biopsy showed papillary adenoma with low grade dysplasia. Additional endoscopic papillectomy was performed. Endoscopic biopsy done 3 months later showed papillary adenoma with high grade dysplasia. Pylorus preserving pancreatoduodenectomy was done and final pathology was well differentiated adenocarcinoma. The patient was recovered well but received adjuvant chemotherapy due to metastatic lymph nodes.
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KEYWORD
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Idiopathic recurrent pancreatitis, Adenocarcinoma of ampulla of vater
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