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. 2009 Sep 28;3(1):23.
doi: 10.1186/1754-9493-3-23.

Management of synchronous adenocarcinoma of the esophago-gastric junction and ampulla of Vater: case report of a surgically challenging condition

Namita Jayaprakash  1 , Fardod O'Kelly, Kheng Tian Lim, John Vincent Reynolds
Affiliations

Management of synchronous adenocarcinoma of the esophago-gastric junction and ampulla of Vater: case report of a surgically challenging condition

Namita Jayaprakash et al. Patient Saf Surg. .

Abstract

We report herein a case of a synchronous presentation of an adenocarcinoma of esophagago-gastric junction type II and an ampullary tumor that was treated by combined Whipple's pancreaticoduodenectomy, total gastrectomy and esophagectomy. The magnitude of this operation was safely achieved with meticulous surgical techniques and perioperative care without any major short or long term complications. Patient returned to a good quality of life at six-month follow up with no further gastrointestinal symptoms or evidence of disease recurrence.

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Figures

Figure 1
Figure 1
An upper gastrointestinal endoscopy showed irregular AGE Type II junctional tumour with a tongue of Barrett's esophagus.
Figure 2
Figure 2
EUS demonstrated significant dilatation of both the CBD (12 mm in diameter) and MPD (7 mm in distal portion).
Figure 3
Figure 3
EUS demonstrated a 12 mm homogeneous ampullary tumour with no significant loco-regional nodes.
Figure 4
Figure 4
Abdominal Computed Tomography showed the double duct sign.
Figure 5
Figure 5
Endoscopic view during ERCP showed a large ampullary tumour.
Figure 6
Figure 6
A drawing illustrating the liver (L), pancreas (P), hepatico-jejunostomy (H-J), pancreatico-jejunostomy (P-J), esophago-jejunostomy (E-J) and jejuno-jejunostomy (J-J) anastomoses.
See this image and copyright information in PMC

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