Related Experiment Video
Updated: Aug 9, 2026

Complete Laparoscopic Radical Resection of Perihilar Cholangiocarcinoma Type IIIb
Published on: January 17, 2025
Distal cholangiocarcinoma associated with papillitis with viral CMV inclusions
Jaime Ruiz-Tovar1, Elena Martín-Pérez, Carlos Gamallo-Amat
1Department of Surgery, University Hospital Ramón y Cajal, Madrid, Spain. jrtovar@wanadoo.es
Abstract:
Cytomegalovirus (CMV) infections are usually described in immunodeficient patients. In immunocompetent patients active infection is uncommon, consisting usually of a mononucleosis-like syndrome. Numerous reports show that CMV is a potential pathogen in the gastrointestinal tract, even in immunocompetent patients, where it can produce lesions from the mouth to the anus. We report herein an uncommon association of chronic inflammation of the papilla and viral CMV inclusions with distal cholangiocarcinoma in a 72-year-old woman who presented jaundice, choluria, acholia and generalized pruritus. At laparotomy, dilatation of the bile ducts and an enlarged head of the pancreas were found. Pancreatoduodenectomy was performed. Pathology revealed an enlarged papilla, due to chronic inflammation with CMV inclusions. Histological analysis revealed moderately differentiated ductal adenocarcinoma of the distal bile tract.
Related Concept Videos
Cytomegalovirus Disease
Appendicitis
Cholecystitis
Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Chronic Pancreatitis I: Introduction
Chronic Pancreatitis II: Pathophysiology
