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Transduodenal surgical ampullectomy for intra-ampullary papillary tubular neoplasm (IAPN): A case report
Susan Pradhan1, Krishna Mohan Adhikari1, Romi Dahal1
1Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Institute of Kathmandu, Nepal.
Introduction And Importance:
Intra-ampullary papillary tubular neoplasms (IAPNs) are relatively rare kind of neoplasms occurring in the region of the papilla which exhibit significant malignant transformation. The patient was concerned about his pain and the possibility of malignancy.
Case Presentation:
We report a case of a 47-year-old male who presented with persistent upper abdomen pain. Following detail investigations, he was diagnosed as IAPN and managed by transduonal ampullectomy (TDA).
Clinical Discussion:
The insidious onset of IAPN along with its high risk of malignancy makes it mandatory for its proper treatment. Although, endoscopic approach is advantageous for initial therapy, it has some technical difficulties. Hence TDA forms the cornerstone in the management of IAPN with good prognosis.
Conclusion:
Transduodenal ampullectomy is a safe and feasible option for IAPN. It can be the first choice of treatment in selected cases where endoscopic papillectomy is not available.
