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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 bleeding. It was first described in the British Medical Journal by Dr. H. Ogilvie in 1955. [4]
Other indicators include raised indicators of ampulla of vater (pancreatic duct obstruction) such as lipases and amylases. In prolonged cases the international normalized ratio (INR) may change due to a decrease in vitamin K absorption. (It is the decreased bile flow which reduces fat breakdown and therefore absorption of fat soluble vitamins).
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.
The duodenal bulb (also ampulla of duodenum, duodenal ampulla, or duodenal cap) is the initial, dilated portion of (the superior part of) the duodenum [1] just distal to the stomach; it begins at the pylorus and ends at the neck of the gallbladder. It is normally about 5 centimeters long. [2]
The gallbladder has a capacity of about 50 millilitres (1.8 imperial fluid ounces). [2] The gallbladder is shaped like a pear, with its tip opening into the cystic duct. [4] The gallbladder is divided into three sections: the fundus, body, and neck. The fundus is the rounded base, angled so that it faces the abdominal wall.
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
The increased pressure in the gallbladder leads to swelling and pain. This pain, known as biliary colic, is sometimes referred to as a gallbladder "attack" because of its sudden onset. During a cholecystectomy, the cystic duct is clipped two or three times and a cut is made between the clips, freeing the gallbladder to be taken out.
Jaundice is commonly caused by conditions such as pancreatic cancer, which causes blockage of the bile duct passing through the cancerous portion of the pancreas; cholangiocarcinoma, cancer of the bile ducts; blockage by a stone in patients with gallstones; and from scarring after injury to the bile duct during gallbladder removal.