Open AccessObstructive jaundice and acute cholangitis due to papillary stenosis
Author(s) -
Jong-Moon Chung,
Jun Sik Cho,
Young Nyun Park,
Se Joon Lee,
Kwan Sik Lee,
Jae Bock Chung,
Sang In Lee,
Jin Kyung Kang,
Ki Whang Kim,
Sang Hoon
Publication year - 1999
Publication title -
yonsei medical journal/yonsei medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.702
H-Index - 63
eISSN - 1976-2437
pISSN - 0513-5796
DOI - 10.3349/ymj.1999.40.2.191
Subject(s) - medicine , major duodenal papilla , stenosis , gastroenterology , malignancy , fibrosis , jaundice , pancreatitis , pancreaticoduodenectomy , pancreas
Papillary stenosis is characterized by fixed fibrosis leading to structural outflow obstruction and it is usually secondary to inflammation and fibrosis from the chronic passage of gallstones, episodes of acute pancreatitis, chronic pancreatitis, sclerosing cholangitis, peptic ulcer disease, and cholesterolosis. However, obstructive jaundice with or without acute cholangitis which leads the physician to suspect the presence of malignancy as a cause is a rare manifestation of papillary stenosis. We report here a case of papillary stenosis presenting with obstructive jaundice and acute cholangitis. The lesion was so difficult to exclude the presence of malignancy preoperatively and intraoperatively that a pylorus-preserving pancreaticoduodenectomy was performed. Histologic examination of the resected specimen revealed fibrosis, adenomatoid ductal hyperplasia, and mild chronic inflammation of the papilla of Vater and distal common bile duct.