Related Experiment Video
Updated: Sep 26, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Ampulla of Vater Metastasis From Colon Cancer Presenting As Obstructive Jaundice
Palash Gupta1, Kuppusamy Senthamizhselvan1, Pazhanivel Mohan1
1Department of Medical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.
Abstract:
A woman in her late 60s presented with obstructive jaundice. She had mucinous adenocarcinoma of the colon six months ago and underwent surgery followed by adjuvant chemotherapy. A computed tomography scan revealed a prominent ampulla with duodenal wall thickening, dilated intrahepatic biliary radicles, bile ducts, and the main pancreatic duct. Duodenoscopy revealed a bulky, friable, and ulcerated ampulla of Vater (AOV) with partial luminal narrowing. The biopsy and immunohistochemistry (IHC) confirmed adenocarcinoma of colonic origin metastasizing to the AOV. She underwent an endoscopic retrograde cholangiogram and biliary drainage, and best supportive care before dying of her illness. Metastatic involvement of AOV is extremely rare. This case reiterates the need to consider AOV metastasis in the differential diagnosis of obstructive jaundice, especially in patients with a history of malignancy. It also underscores the role of IHC to differentiate AOV primary malignancy from metastasis.
Related Concept Videos
Jaundice
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Portal Hypertension
Pyloric Obstruction
Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Cholecystitis
