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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 ...
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
Other biliary tract cancers include gallbladder cancer and cancer of the ampulla of Vater. [7] Risk factors for cholangiocarcinoma include primary sclerosing cholangitis (an inflammatory disease of the bile ducts), ulcerative colitis, cirrhosis, hepatitis C, hepatitis B, infection with certain liver flukes, and some congenital liver malformations.
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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]
A worm may block the ampulla of Vater, or go into the main pancreatic duct, resulting in acute pancreatitis with raised serum levels of amylase and lipase. Occasionally, a worm can travel through the biliary tree and even into the gallbladder , causing acute cholangitis or acute cholecystitis .
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.
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.