Yonsei Med J.  1999 Apr;40(2):191-194. 10.3349/ymj.1999.40.2.191.

Obstructive jaundice and acute cholangitis due to papillary stenosis

• Chung JP
• Cho JS
• Park YN
• Lee SJ
• Lee KS
• Chung JB
• Lee SI
• Kang JK
• Kim KW
• Chi HS

• KMID: 711635
• DOI: http://doi.org/10.3349/ymj.1999.40.2.191

Abstract

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.

Keyword

Papillary stenosis; obstructive jaundice; pancreaticoduodenectomy

MeSH Terms

Acute Disease
Case Report
Cholangitis/etiology*
Cholestasis/etiology*
Cholestasis/complications*
Common Bile Duct Diseases/complications*
Human
Male
Middle Age
Vater's Ampulla*/radiography
Vater's Ampulla*/pathology