A Case of Acute Recurrent Pancreatitis Caused by Branch Duct Type IPMN and Ampulla of Vater Adenoma with High Grade Dysplasia

Oh, Chang Kyo; Yoo, Ki Deok; Choi, Ho Soon; Lee, Kang Nyeong; Koo, Gun Woo; Lee, Seung; Jang, Ki Seok

doi:2014.87.5.579

Korean J Med > Volume 87(5); 2014 > Article

Case Report

The Korean Journal of Medicine 2014;87(5):579-584.
Published online November 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.87.5.579

A Case of Acute Recurrent Pancreatitis Caused by Branch Duct Type IPMN and Ampulla of Vater Adenoma with High Grade Dysplasia

Chang Kyo Oh¹, Ki Deok Yoo¹, Ho Soon Choi¹, Kang Nyeong Lee¹, Gun Woo Koo¹, Seung Lee¹, Ki Seok Jang²

¹Departments of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
²Departments of Pathology, Hanyang University College of Medicine, Seoul, Korea

췌관내유두상점액종양과 바터 팽대부 선종에 의한 급성 재발성 췌장염

오창교¹, 유기덕¹, 최호순¹, 이강녕¹, 구건우¹, 이승¹, 장기석²

^¹한양대학교 의과대학 내과학교실
^²한양대학교 의과대학 병리학교실

Correspondence:
Ho Soon Choi, Tel: +82-2-2290-8379, Fax: +82-2-2298-9183, Email: hschoi96@hanyang.ac.kr

Received: 22 April 2014 • Revised: 2 June 2014 • Accepted: 23 June 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute pancreatitis is an inflammatory disease that can extend to extra-pancreatic tissues and distant organs. Detecting the underlying cause is important because it helps provide an appropriate treatment plan and improve prognosis. An underlying cause cannot be identified after initial evaluation in 10-30% of patients with acute pancreatitis, and they are diagnosed with idiopathic acute pancreatitis. Here, we report a case of a 77-year-old woman with acute recurrent pancreatitis caused by a branch duct-type intraductal papillary mucinous neoplasm (IPMN) and an ampulla of Vater adenoma. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed only IPMN. However, endoscopic retrograde cholangiopancreatography revealed a mucosal abnormality of the ampulla of Vater. The mucosal abnormality was documented to be an ampulla of Vater adenoma with high-grade dysplasia.

Key Words: Pancreatitis; Ampulla of Vater; Adenoma; Intraductal papillary mucinous neoplasm (IPMN)

주제어: 췌장염; 바터 팽대부; 선종; 췌관내유두상점액 종양