Challenges in the management of adenocarcinoma of ampulla of Vater in pregnancy: A case report and review of literature.
| Autor: | AlQattan AS; Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Electronic address: a.qattan.94@gmail.com., Alkuwaiti FA; Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Alghusnah ES; Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Bojal SA; Department of General Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia., Alqahtani MS; Department of General Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | International journal of surgery case reports [Int J Surg Case Rep] 2019; Vol. 61, pp. 38-43. Date of Electronic Publication: 2019 Jun 26. |
| DOI: | 10.1016/j.ijscr.2019.06.044 |
| Abstrakt: | Introduction: Ampullary adenocarcinoma is a rare entity during pregnancy. It accounts for 0.5% of all gastrointestinal malignancies. The best treatment modality for resectable tumors with the best reported outcome is surgical resection in the form of pancreaticoduodenectomy (Whipple procedure). In this case report, we discuss the challenges in the management of ampullary adenocarcinoma in a pregnant patient. Case Presentation: We report a case of 22 years old pregnant women who presented with vague abdominal pain and jaundice at the 28th week of gestation. Endoscopic retrograde cholangiopancreatography (ERCP) showed a stricture around the ampulla and distal common bile duct (CBD). The CBD was stented and a biopsy was taken. Histopathology revealed: an invasive adenocarcinoma. The patient was managed by elective pancreaticoduodenectomy after induction of vaginal delivery at the 34th week of gestation. Conclusion: Diagnosing and managing ampullary adenocarcinoma in pregnant patients in their 3rd trimester is challenging. Yet, a delayed viable delivery followed by a definitive surgery in the form of pancreaticoduodenectomy offers the best outcomes for both the mother & fetus in case of early stage disease. (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|