Hemangioma of the major duodenal papilla complicated with bleeding

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Abstract

Herein we report a case of hemangioma with a rare localization in the major duodenal papilla presenting with a recurrent intraluminal bleeding in a 60-years old patient. Late onset, clinical and endoscopic signs suspicious for malignancy and inability to rule out cancer by preoperative biopsy defined an aggressive surgical approach. The patient underwent classical Whipple procedure after failing an attempt of endovascular embolization of the posterior pancreatoduodenal artery with unfavorable surgical outcome. Available preoperative diagnostic modalities and their accuracy levels are discussed.

About the authors

Vasilisa Yu. Rayn

Khanty-Mansiysk state medical academy; District Clinical Hospital of the Khanty-Mansiysk Autonomous Okrug – Ugra

Author for correspondence.
Email: raynvu@okbhmao.ru
ORCID iD: 0000-0003-2406-0000
SPIN-code: 9455-8350

graduate student (department for general surgery, Khanty-Mansiysk State medical academy), surgeon (department for general surgery № 2 of the District Clinical Hospital of Khanty-Mansiysk, Russia

Russian Federation, 628011, Khanty-Mansiysk, Mira 40; 628012, Khanty-Mansiysk, Kalinina 40

Vladimir P. Ionin

Khanty-Mansiysk state medical academy

Email: ionin.55@mail.ru

Doctor of Medical Sciences, Professor, Head of the Department of General and Faculty Surgery

Russian Federation, 628011, Khanty-Mansiysk, Mira 40

M A. Persidskiy

District Clinical Hospital of the Khanty-Mansiysk Autonomous Okrug – Ugra

Email: mixajich@mail.ru

doctor of the first category of the pathoanatomical department

Russian Federation, 628012, Khanty-Mansiysk, Kalinina 40

References

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Supplementary files

Supplementary Files
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2. Fig. 1. Endoscopic view of the Vater’s papilla tumor after initiation of treatment with proton pump inhibitors

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3. Fig. 2. Tumor of the major duodenal papilla obtained via endoscopic biopsy at ×40 magnification. H&E

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4. Fig. 3. Specimen section: whitish dense tumor in the head of the pancreas

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5. Fig. 4. Haemangioma located in the papilla of Vater at ×200 magnification. H&E

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Copyright (c) 2020 Rayn V.Y., Ionin V.P., Persidskiy M.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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