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April 1984

Villous Adenoma of the Duodenum Producing Intussusception

Arch Surg. 1984;119(4):487. doi:10.1001/archsurg.1984.01390160109025

To the Editor.—We report the first known case of acute pancreatitis caused by duodenojejunal intussusception secondary to villous adenoma of the third portion of the duodenum.

Report of a Case.—A 73-year-old woman was admitted to the Surgical Service of St Luke's Hospital, New York, with a 12-hour history of severe, cramping, midepigastric pain associated with nausea and emesis of bilious material. She was afebrile and her abdomen was moderately distended, with marked tenderness in the epigastrium. There were no peritoneal signs, nor were any masses palpated. Results of a rectal examination were unremarkable, and a guaiac test of a stool specimen was negative. Abnormal laboratory values included the following values: serum amylase, 7,100 Somogyi units/dL; lactic dehydrogenase, 262 units/L; and SGOT, 55 units/L. A sonogram of the biliary tree was normal. A barium study of the upper gastrointestinal tract showed intussusception of the third portion of the duodenum