Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 180] 27-year-old Female Diagnosed with Ampullary Adenocarcinoma and Managed During 2nd Trimester of Pregnancy: A Case Report
Gracielle Marie E. Dideles, Jaime F. Ocsio Jr., Walter G. Batucan, Rolley Rey Lobo, Mario Rogelio Magnaye, Romulo S. Ong Abrantes, Josil R. Cruz, Gracielle Marie Dideles
Department of Surgery, Division of Hepatopancreatobiliary Surgery, Southern Philippines Medical Center, Davao City, Davao Del Sur, Philippines
Background : 0
Methods : 0
Results : 0
Conclusions : We report a case of a gravid 27-year-old Filipino Female who presented with loss of consciousness, pallor and icterisia during her 20th week age of gestation. Pre-operative work up initially showed marked anemia and moderate cholangitis which was managed medically through blood transfusion and antibiotics. CA 19 – 9 was markedly elevated. Initial abdominal ultrasound results noted gallbladder hydrops with diffuse biliary ectasia secondary to a pancreatic head mass. Endoscopic retrograde cholangiography was attempted but was unable to cannulate the ampulla which revealed a friable ulcerated nodular lesion at the ampulla. Histopathology results show a poorly differentiated adenocarcinoma. Abdominal MRI done revealed a resectable T2 hyperintense mass within the distal common bile duct to the ampullary area with no vascular involvement or distant metastases. Patient was subsequently subjected to a Whipple’s procedure during her 24th week age of gestation. Intraoperatively, there was an incidental finding of a hepatic nodule which was biopsied and sent for frozen section showing chronic granulomatous inflammation with foreign body type giant cell reaction with a consideration of hepatic tuberculosis. Complete surgical resection was done and patient was discharged stable. Patient was subsequently advised for adjuvant chemotherapy and was able to deliver via spontaneous vaginal delivery to a live, term, baby girl with good APGAR but small for gestational age. This paper presents a rare case of an ampullary adenocarcinoma diagnosed and managed during the 2nd trimester of pregnancy highlighting careful management with good outcomes for both the mother and baby.
Methods : 0
Results : 0
Conclusions : We report a case of a gravid 27-year-old Filipino Female who presented with loss of consciousness, pallor and icterisia during her 20th week age of gestation. Pre-operative work up initially showed marked anemia and moderate cholangitis which was managed medically through blood transfusion and antibiotics. CA 19 – 9 was markedly elevated. Initial abdominal ultrasound results noted gallbladder hydrops with diffuse biliary ectasia secondary to a pancreatic head mass. Endoscopic retrograde cholangiography was attempted but was unable to cannulate the ampulla which revealed a friable ulcerated nodular lesion at the ampulla. Histopathology results show a poorly differentiated adenocarcinoma. Abdominal MRI done revealed a resectable T2 hyperintense mass within the distal common bile duct to the ampullary area with no vascular involvement or distant metastases. Patient was subsequently subjected to a Whipple’s procedure during her 24th week age of gestation. Intraoperatively, there was an incidental finding of a hepatic nodule which was biopsied and sent for frozen section showing chronic granulomatous inflammation with foreign body type giant cell reaction with a consideration of hepatic tuberculosis. Complete surgical resection was done and patient was discharged stable. Patient was subsequently advised for adjuvant chemotherapy and was able to deliver via spontaneous vaginal delivery to a live, term, baby girl with good APGAR but small for gestational age. This paper presents a rare case of an ampullary adenocarcinoma diagnosed and managed during the 2nd trimester of pregnancy highlighting careful management with good outcomes for both the mother and baby.
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E-poster
E-Session 03/21 ALL DAY