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March 1966

PapillitisInflammatory Disease of the Ampulla of Vater

Author Affiliations

From the Cátedra de Clinica Quirúrgica de Ciencias Médicas de la Universidad Nacional del Litoral, Rosario, Argentina, and the Department of Surgery, Harvard Medical School, and the Surgical Services, Massachusetts General Hospital, Boston.

Arch Surg. 1966;92(3):354-361. doi:10.1001/archsurg.1966.01320210034006

STENOSIS of the lower end of the common bile duct without choledocholithiasis has been recognized for many years.5,11, 17,23,31 However, Delfor Del Valle11 first described the pathology of this lesion in 1926, interpreting it as a benign inflammatory and fibrous process, which he called "Colédoco-Odditis Esclero-retráctil." He also described the clinical syndrome produced by the stenosis and considered the possibility of making a preoperative diagnosis.

Recent investigations1-4,6,17,20,24-26,29 have established that the scarring which produces the stenosis is the final and irreversible result of inflammatory changes. In addition, subacute and acute inflammatory lesions have been identified; they may be reversible, as are their clinical manifestations. However, simple edema can cause complete obstruction either of the common bile duct or Wirsung's duct with resulting cholangitis, obstructive jaundice, or pancreatitis. In this context, it is appropriate to remember that urticaria may be a trivial allergic phenomenon, but Quincke's edema because

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