July 2013

Bile duct dilatation and a mass at Vaters papil

Bookmark

Clinical information

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

Another image of the liver with dilatated bile ducts

The common bile duct is massively dilatated and measures 3,5 cm

There is a large gallbladder with a layer of thickened bile

Detail of the common bile duct ending in a rounded mass

Another image of the common bile duct and tumor mass

Image of the pancreatic duct that is slightly dilatated

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

Fujifilm Ultrasound System

Browse through our ultrasound product portfolio

Looking for MSK Ultrasound Education? Visit Sonoskills.com

Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

More Cases from Taco Geertsma

[{"listLocation":"abdomen-and-retroperitoneum","icon":"001-abdomen-white.svg","header":"Abdomen and retroperitoneum","id":63},{"listLocation":"urinary-tract-and-male-reproductive-system","icon":"002-urinary-tract-white.svg","header":"Urinary Tract and male reproductive system","id":64},{"listLocation":"gynaecology","icon":"003-gynaecology-white.svg","header":"Gynaecology","id":65},{"listLocation":"head-and-neck","icon":"004-head-neck-white.svg","header":"Head and Neck","id":66},{"listLocation":"breast-and-axilla","icon":"005-breast-white.svg","header":"Breast and Axilla","id":67},{"listLocation":"musculo-skeletal-joints-and-tendons","icon":"006-msk-joints-white.svg","header":"Musculoskeletal Joints and Tendons","id":68},{"listLocation":"musculo-skeletal-bone-muscle-nerves-and-other-soft-tissues","icon":"007-msk-bones-white.svg","header":"Musculoskeletal, bone, muscle, nerves and other soft tissues","id":69},{"listLocation":"thorax","icon":"008-thorax-white.svg","header":"Thorax","id":70},{"listLocation":"pediatrics","icon":"009-pediatrics-white.svg","header":"Pediatrics","id":71},{"listLocation":"peripheral-vessels","icon":"010-peripheral-vessels-white.svg","header":"Peripheral vessels","id":72}]