ADENOMYOMA OF THE AMPULLA OF VATER - AN UNCOMMON CAUSE OF BILE-DUCT OBSTRUCTION

Adenomyomas of the bile ducts are extremely rare. They are most likely often overlooked also when situated in the ampulla of Vater and obstr ucting bile flow. Of 3,131 endoscopic retrograde cholangiograms, four patients with ampullary adenomyoma and signs of biliary obstruction ha ve been diagnosed. When recognized they can be treated effectively by endoscopic means. However, their radiologic and endoscopic appearances were found difficult to interpret and led to unnecessary endoscopic s essions in one patient and surgery in another. Thus, increased awarene ss of this entity is important to avoid overlooking or misdiagnosing i t.