An unexpected guest in the duodenal ampulla: Tales apart from Rapunzel

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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The pancreas, an essential organ in the human body, is a pinkish-gray elongated structure located posterior to the stomach. It extends laterally from the duodenum towards the spleen and is firmly bound to the posterior wall of the abdominal cavity. The organ's surface has a lumpy, lobular texture that gives it a unique appearance.
The broad head of the pancreas lies within the loop formed by the duodenum, while its slender body reaches towards the spleen. The tail of the pancreas is short...

The small intestine exhibits a unique histological structure that significantly enhances its function in digestion and nutrient absorption. These structures include circular folds, villi, and various specialized cells that collectively facilitate the digestion of food.
The intestinal lining features transverse folds called circular folds, each housing fingerlike projections known as intestinal villi. These villi are covered by a layer of simple columnar epithelium, also referred to as...

An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:

The human stomach is a vital part of the digestive system, performing multiple functions. It is located within the peritoneum, a serous membrane that lines the abdominal cavity. The stomach plays a central role in processing food substances and interacts with other digestive organs through coordinated digestive processes. The stomach has a characteristic J-shape and is divided into four main regions. The cardia is the first section where the esophagus connects to the stomach and is the entry...

The intestinal phase of digestion is the third and final stage of the digestive process, occurring after the cephalic and gastric phases. It begins when chyme, a partially digested mixture of food and digestive enzymes, enters the small intestine from the stomach. This phase is crucial for nutrient absorption and involves complex hormonal and enzymatic interactions.
The arrival of the chyme in the small intestine distends the duodenum, which triggers the enterogastric reflex. This distension...