[Villous adenoma of the papilla of Vater and acute necrotizing pancreatitis]

Abstract

In two patients a villous adenoma of the papilla of Vater was found to be the cause of an acute necrotizing pancreatitis. The diagnosis was largely made by early gastroduodenoscopy and endoscopic retrograde cholangiopancreatography. After initially conservative treatment of the pancreatitis the adenoma was excised transduodenally in both patients. Histological examination in both revealed a completely removed benign villous adenoma. Both patients have remained free of symptoms after 18 and 6 months, respectively. These observations support the call for intensive diagnostic measures when a diagnosis of pancreatitis has been made: tumours of the pancreas and of the periampullar region should be ruled out.