Document Detail


Common bile duct papillary adenoma causing obstructive jaundice: case report and review of the literature.
MedLine Citation:
PMID:  15156955     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Common bile duct (CBD) adenomas are rare tumors that often present in a fashion similar to their malignant counterparts. We report a case of a papillary CBD adenoma causing obstructive jaundice. We also present a review of the CBD adenomas found in the English literature through a Medline search (1970-2003). A 74-year-old female presented with a 10-day history of pruritus, progressive painless jaundice, acholic stools, bilirubinuria, and 10-lb weight loss. Abdominal exam showed no masses. Abdominal ultrasound (U/S) showed cholelithiasis without choledocholithiasis. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic U/S revealed a shelf-like stricture, 1.5 cm long and 0.9 cm in diameter, located in the distal CBD. At the time of biliary stent placement, fine-needle aspiration showed benign ductal epithelial cells in sheets and clusters. Abdominal CT scan showed a low attenuation 15 x 17 mm lesion in the head of the pancreas that abutted the superior mesenteric vein (SMV) but no metastatic lesions. We performed a standard pancreaticoduodenectomy (Whipple procedure). Final pathology showed a papillary adenoma without evidence of dysplasia in the distal common bile duct proximal to the ampulla of Vater. The incidence of these tumors and their potential for malignant degeneration is unknown. Pancreaticoduodenectomy is an effective means of treatment and cure for CBD adenoma.
Authors:
Nicholas D Fletcher; Paul E Wise; Kenneth W Sharp
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The American surgeon     Volume:  70     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-25     Completed Date:  2004-06-08     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  448-52     Citation Subset:  IM    
Affiliation:
Department of Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / complications,  diagnosis,  surgery*
Aged
Biopsy, Needle
Cholangiopancreatography, Endoscopic Retrograde
Cholelithiasis / etiology
Common Bile Duct Neoplasms / complications,  diagnosis,  surgery*
Diagnosis, Differential
Endosonography
Female
Humans
Hyperbilirubinemia / etiology
Immunohistochemistry
Jaundice, Obstructive / etiology*
Pancreaticoduodenectomy
Pruritus / etiology
Stents
Tomography, X-Ray Computed
Treatment Outcome
Weight Loss

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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