July 2013

Bile duct dilatation and a mass at Vaters papil

Clinical Info

Patient with neurofibromatosis (von Recklinghausen). Jaundice without pain or other symptoms.

Ultrasound Images & Clips

Tumor mass at Vaters papil

Liver with dilatated intrahepatic bile ducts
Liver with dilatated intrahepatic bile ducts
Another image of the liver with dilatated bile ducts
Another image of the liver with dilatated bile ducts
The common bile duct is massively dilatated and measures 3,5 cm
The common bile duct is massively dilatated and measures 3,5 cm
There is a large gallbladder with a layer of thickened bile
There is a large gallbladder with a layer of thickened bile
Detail of the common bile duct ending in a rounded mass
Detail of the common bile duct ending in a rounded mass
Another image of the common bile duct and tumor mass
Another image of the common bile duct and tumor mass
Image of the pancreatic duct that is slightly dilatated
Image of the pancreatic duct that is slightly dilatated
Another image of the rounded mass at the papil
Another image of the rounded mass at the papil
CT scan

Conclusion

The jaundice was caused by a tumor mass at Vaters papil with obstruction of the common bile duct and to a lesser degree of the pancreatic duct.
An endoscopy failed because the endoscope could not reach the papil. The patient was referred to a university center.
The mass proved to be a neuro endocrine tumor of Vaters papil. This is a fairly uncommon mass but is seen more frequently in patients with neurofibromatosis. Patient underwent a Whipple procedure


Details

  • Sex: Female
  • Age: 73

Created with

  • Hitachi Ultrasound System