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15 December 2018 : Case report  Japan

Acute Pancreatitis Caused by Ampullary Duodenum Adenoma in a Patient with Adenomatous Polyposis Coli with Billroth II Reconstruction After Distal Gastrectomy

Rare disease

Takao Iemoto1AEF, Tsuyoshi Sanuki1AEF*, Takayuki Ose1F, Tomoo Yoshie1F, Katsuhide Tanaka1F, Ayaka Sasaki1F, Shohei Abe1F, Tetsuyuki Abe1F, Mika Miki1F, Ryoko Futai1F, Yuta Inoue1F

DOI: 10.12659/AJCR.912248

Am J Case Rep 2018; 19:1495-1498

Abstract

BACKGROUND: Adenomatous polyposis coli is an autosomal dominant hereditary disorder. Duodenal adenocarcinoma and adenoma, which are extracolonic lesions, not only affect the prognosis of patients but also cause acute pancreatitis.

CASE REPORT: We present the case of a 73-year-old male. He had undergone proctocolectomy for familial adenomatous polyposis and distal gastrectomy (Billroth II reconstruction with Braun anastomosis) for gastric ulcer; he presented with acute pancreatitis caused by ampullary duodenum adenoma. Double-balloon endoscopy showed 2 adenomatous polyps in the major papilla and descending limb of the duodenum. Based on the findings of endoscopy and biopsy, the duodenal polyps were diagnosed as adenomas and classified as Spigelman stage II.

CONCLUSIONS: Our case report suggests that duodenal surveillance is necessary for patients with adenomatous polyposis coli. In addition, surveillance using double-balloon endoscopy is useful for patients with an altered gastrointestinal anatomy.

Keywords: Adenomatous Polyposis Coli, Gastroenterostomy

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923