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Thomas' sign is the production of silver stools and can be indicative of cancer of the Ampulla of Vater. The ampulla of Vater is the site of tumors, often with a threatening prognosis and difficult surgical treatment. The silver-colored stool is a combination of the white stool of obstructive jaundice combined with black stool of melena or ...
Intra-ampullary papillary–tubular neoplasms (IAPN) are precancerous neoplasms of the ampulla of Vater. [1] On histological examination the neoplasms exhibit both papillary and tubular features. [2] IAPN were first described in 2010. [1] They are rare; comprising 0.5% of gastrointestinal tumours. [1]
Periampullary cancer is a cancer that forms near the ampulla of Vater, an enlargement of the ducts from the liver and pancreas where they join and enter the small intestine. [1] It consists of: ampullary tumour from ampulla of Vater; cancer of lower common bile duct; duodenal cancer adjacent to ampulla; carcinoma head of pancreas
Symptoms of cholangiocarcinoma may include abdominal pain, yellowish skin, weight loss, generalized itching, and fever. [1] Light colored stool or dark urine may also occur. [4] Other biliary tract cancers include gallbladder cancer and cancer of the ampulla of Vater. [7]
The major duodenal papilla (papilla of Vater) is a rounded projection in the duodenum into which the common bile duct and pancreatic duct drain. The major duodenal papilla is, in most people, the primary mechanism for the secretion of bile and other enzymes that facilitate digestion.
The double duct sign is a radiological finding characterized by the simultaneous dilation of the common bile duct and the main pancreatic duct.This sign is significant because it often indicates an obstruction in the distal bile duct and pancreatic duct, frequently caused by serious underlying pathologies such as pancreatic carcinoma or periampullary tumors. [1]
The law does not say that these symptoms automatically mean pancreatic cancer. It just happens that pancreatic cancer is the most common cause that falls under Courvoisier's law. [4] Other cause includes malignancy of the CBD (i.e. cholangiocarcinoma), head of pancreas and ampulla of Vater.
The bile duct is some 6–8 cm long, and normally up to 8 mm in diameter. [4]Its proximal supraduodenal part is situated within the free edge of the lesser omentum.Its middle retroduodenal part is oriented inferiorly and right-ward, and is situated posterior to the first part of the duodenum, and anterior to the inferior vena cava.