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September 1968

Ampullary Obstruction by Benign Duodenal Polyps

Author Affiliations

Lexington, Ky
From the departments of surgery and medicine, University of Kentucky College of Medicine, Lexington.

Arch Surg. 1968;97(3):444-449. doi:10.1001/archsurg.1968.01340030104009

OBSTRUCTION TO the outflow of bile or pancreatic juice usually produces findings which lead to surgery. The common causes of pancreatic or biliary tract obstruction seldom pose a diagnostic problem. The dilemma arises in the patient who presents with an unusual obstructing lesion, atypical symptoms, or without corroborative biochemical or roentgenographic changes. We have recently encountered five such patients with benign periampullary polyps associated with pancreaticobiliary obstruction. The purpose of this report is to define the entity and emphasize some diagnostic and therapeutic measures in the care of these patients.

Report of Cases  Case 1 (CBH 110427).—This 69-year-old woman was admitted Oct 29, 1965 with rightsided abdominal pain of four hours' duration. For several weeks she had had recurring episodes of similar pain associated with nausea. A cholecystogram four days prior to admission showed faint visualization of the gallbladder without stones. She had moderate hypertension treated successfully with thiazides for

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