Common Bile Duct Papillary Adenoma Causing Obstructive Jaundice: Case Report and Review of the Literature

Fletcher, Nicholas D.; Wise, Paul E.; Sharp, Kenneth W.
May 2004
American Surgeon;May2004, Vol. 70 Issue 5, p448
Academic Journal
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 10-1b weight loss. Abdominal exam showed no masses. Abdominal ultrasound (U/S) showed cholelithiasis without choledo-cholithiasis. 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.


Related Articles

  • Laparoscopic Common Bile Duct Exploration. Neelamekam, T. K.; Balachandran, Premkumar // World Journal of Laparoscopic Surgery;May-Aug2010, Vol. 3 Issue 2, p59 

    Stones in the common bile duct are a common finding and is one of the most common cause for obstructive jaundice. These calculi may be primary ductal stones or secondary, which descend from the gallbladder. There are various therapeutic options for its management and could vary from chemical to...

  • Evaluation of Serum Guanase in Clinical Diagnosis. Mandel, Emanuel E.; Macalincag, Lilia R.; Tiongson, Teresita; Tiongson, Estelita // American Journal of Gastroenterology;Sep1970, Vol. 54 Issue 3, p253 

    Serum guanase was measured in 301 patients with hepatobiliary disorders and in 99 patients suffering from other diseases. It was found elevated (above 5 units per ml.) on initial examination in 92 per cent of 103 patients with acute hepatitis, 67 per cent of 55 patients with obstructive jaundice...

  • Primary Gastrointestinal Lymphoma Complicated by Common Bile Duct Obstruction: Report of Two Cases. Radhakrishnan, S.; Al Nakib, Basil; Al Liddawi, Hani; Al Ruwaih, Ayad // American Journal of Gastroenterology;Aug1986, Vol. 81 Issue 8, p691 

    This report describes two cases, a case of primary small intestinal lymphoma and a case of gastroduodenal lymphoma both producing obstructive jaundice due to invasion of the common bile duct. Oesophagogastroduodenoscopy revealed the lesions and the endoscopic biopsies confirmed the diagnosis of...

  • DRUG RELATED PROBLEMS ASSOCIATED WITH TREATMENT FOR OBSTRUCTIVE JAUNDICE PATIENT IN PGI CIKINI HOSPITAL. Timburas, Mitra Wynne; Ramatillah, Diana Laila; Eff, Aprilita Rinayanti; Lukas, Stefanus // Wood Industry / Drvna Industrija;2015 Supplement1, Vol. 6 Issue 1, p1660 

    Jaundice is the yellow color of skin, eye sclera or mucous membranes due to accumulation of bile pigments in blood and their deposition in body tissues. It commonly caused by gallstones, or tumours of the bile duct and liver disorders. Case presentation : Mr. SS, 68 years old, came to PGI Cikini...

  • cholestasis.  // Royal Society of Medicine: Medicines;2002, p153 

    The article provides information on cholestasis, a failure of the normal bile flow to the intestine causing liver disease and jaundice. Causes include a physical obstructive jaundice due to a stone, liver disease or drug-induced toxic reaction. The symptoms are jaundice with dark urine, pale...

  • Resected case of eosinophilic cholangiopathy presenting with secondary sclerosing cholangitis. Miura, Fumihiko; Asano, Takehide; Amano, Hodaka; Yoshida, Masahiro; Toyota, Naoyuki; Wada, Keita; Kato, Kenichiro; Takada, Tadahiro; Fukushima, Junichi; Kondo, Fukuo; Takikawa, Hajime; Chari, Ravi S. // World Journal of Gastroenterology;3/21/2009, Vol. 15 Issue 11, p1394 

    Eosinophilic cholangiopathy is a rare condition characterized by eosinophilic infiltration of the biliary tract and causes sclerosing cholangitis. We report a patient with secondary sclerosing cholangitis with eosinophilic cholecystitis. A 46-year-old Japanese man was admitted to our hospital...

  • Current Diagnostic and Management Options in Perihilar Cholangiocarcinoma. Rizvi, Sumera; Gores, Gregory J. // Digestion;Jun2014, Vol. 89 Issue 3, p216 

    Cholangiocarcinomas (CCAs) are heterogeneous biliary tract tumors with dismal prognosis. Perihilar CCA (pCCA) involves the large bile ducts of the hepatic hilum, and is the most common type of CCA. Primary sclerosing cholangitis (PSC) is an established risk factor for pCCA. Although the...

  • An algorithm for the treatment of the biliary complications of hepatic hydatid disease. Öztürk, Gürkan; Yildirgan, M. İlhan; Atamanalp, S. Selçuk; Başoğlu, Mahmut; Aydinli, Bülent; Polat, K. Yalçin; Ören, Durkaya; Kisaoğlu, Abdullah // Turkish Journal of Medical Sciences;2009, Vol. 39 Issue 5, p671 

    Aim: The treatment of hepatic hydatid disease (HHD) is currently standardized. Biliary complications of HHD complicate both the treatment and course of the disease. Several investigations have been performed on the biliary complications of HHD and their treatment. We propose an algorithm for the...

  • Radiation-induced stricture of the common bile duct. Campbell, William; Kirk, Gareth; Clements, WD Barry // Internet Journal of Surgery;2008, Vol. 17 Issue 2, p19 

    This 62-year-old female patient presented to surgical outpatients with features of obstructive jaundice ten years following radiotherapy for renal cell carcinoma. Investigations demonstrated an apparently benign mid common bile duct (CBD) stenosis. The lesion was stented giving temporary relief...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics