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Sphincter of Oddi dysfunction caused by an ampullary neoplasm
1Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.
Gastroenterology
|January 1, 1995
Summary
Sphincter of Oddi dysfunction in a 50-year-old man was linked to an ampullary adenoma and carcinoma. This case highlights malignancy as a cause of sphincter dysfunction, similar to pseudoachalasia.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Pathology
Background:
- Sphincter of Oddi dysfunction (SOD) is a functional disorder affecting the biliary and pancreatic systems.
- Ampullary lesions can present with diverse symptoms, including abdominal pain and abnormal liver function tests.
Observation:
- A 50-year-old male presented with abdominal pain and abnormal liver tests.
- Endoscopic retrograde cholangiopancreatography (ERCP) revealed biliary dilatation, poor ductal drainage, and SOD.
- Clinical and imaging findings suggested an ampullary lesion.
Findings:
- Endoscopic sphincterotomy led to the detection of a small ampullary adenoma.
- Operative specimen analysis confirmed ampullary carcinoma.
- The study identified malignancy as a potential cause of SOD.
Implications:
- Malignancy should be considered in the differential diagnosis of SOD, particularly in cases with suspicious ampullary findings.
- This case expands the understanding of how malignancy can induce sphincter dysfunction beyond the esophagus (pseudoachalasia) to the ampulla of Vater.
- Early detection and management of ampullary lesions are crucial for favorable outcomes.
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