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. 2013 Mar;46(2):178-81.
doi: 10.5946/ce.2013.46.2.178. Epub 2013 Mar 31.

A case of enteritis cystica profunda in the ampulla of vater mimicking choledochocele

Kyoung Wan You  1 , Sang Wook Park, Geum Soo Lee, Du Jin Kim, Hyeung Cheol Moon, Gun Young Hong
Affiliations

A case of enteritis cystica profunda in the ampulla of vater mimicking choledochocele

Kyoung Wan You et al. Clin Endosc. 2013 Mar.

Abstract

Enteritis cystica profunda is a very rare disease in which a mucin-filled cystic space is surrounded partially with nonneoplastic columnar epithelium in the submucosa of the small intestine. Most of the cases are accompanied by intestinal diseases, and the disease usually occurs in the jejunum and the ileum and there has been no report of a case that occurred in the ampulla of Vater. A 58-year-old healthy female patient without any particular symptom visited the hospital to get additional examination for a mass found on the ampulla of Vater by accident. In esophagogastroduodenoscopy, a cystic mass showing a positive pillow sign was found on the ampulla of Vater. Endoscopic retrogradecholangiopancreatography was conducted as choledochocele was suspected, but no abnormality was found in the biliary system. In endoscopic ultrasonography, multiseptated cystic structures were detected in the submucosal layer of the duodenum. The lesion was resected completely through endoscopic snare polypectomy and the case was histologically diagnosed as enteritis cystica profunda.

Keywords: Ampulla of Vater; Choledochal cyst; Duodenum; Enteritis cystica profunda.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Esophagogastroduodenoscopy finding. It shows 1 cm-sized softly protruding mass lesion on the ampulla of Vater.
Fig. 2
Fig. 2
Duodenoscopic findings. (A) At the ampulla of Vater, a bulging lesion covered with normal mucosa was found at the proximal part of the major papilla. (B) The pillow sign is positive. (C) The lesion was captured by snare for resection. (D) After snare polypectomy, most of the major papilla was preserved.
Fig. 3
Fig. 3
Endoscopic retrograde cholangiopancreatography finding. It shows no abnormal finding of the bile duct.
Fig. 4
Fig. 4
Endoscopic ultrasonography finding (12-MHz miniprobe). About 8 mm-sized, honeycomb-shaped, multiseptated cystic lesion arising from submucosal layer of duodenum (arrow).
Fig. 5
Fig. 5
Histological finding. Multiple cysts lined mucin-producing glandular cells are located in the submucosa (H&E stain, ×40).
See this image and copyright information in PMC

References

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