Carcinoma of the ampulla of Vater presenting as acute pancreatitis

The presentation of ampullary carcinoma as acute pancreatitis has been documented only in scattered reports but may be more common than is generally appreciated. More typically this uncommon gastrointestinal neoplasm presents with obstructive jaundice, weight loss, anorexia, and nonspecific abdominal pain. A case of ampullary carcinoma is presented in which the clinical features and computed tomographic appearance were those of relapsing, acute pancreatitis. Only after various clinical and radiographic features indicated on ampullary lesion was the etiology of the pancreatitis finally established and a curative resection performed.