Adenomyomatosis of the papilla of Vater: A case illustrating diagnostic difficulties

Aim: To describe the extremely rare case of an adenomyoma of the papilla of Vater. Case Report: A 42-year-old woman was hospitalized for epigastralgia and high fever. The clinical presentation and endoscopic, biochemical, and radiologic findings led to the diagnostic impression of a dysfunction of the papilla of Vater. The patient was treated successfully by laparotomy and duodenotomy, incorporating cholangiomanometry and cholangiography. Intraoperative frozen-section examination of a transduodenal papillectomy specimen led to the diagnosis of adenomyomatosis of the papilla. The patient is doing well 38 months postoperatively. Conclusion: Such a combined approach to intraoperative diagnosis was important to avoid excessive surgery for a benign periampullary disease. Copyright (C) 2001 S. Karger AG, Basel.