Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 7, 2009; 15(9): 1138-1140
Published online Mar 7, 2009. doi: 10.3748/wjg.15.1138
Endoscopic papillectomy of minor papillar adenoma associated with pancreas divisum
Akira Kanamori, Takashi Kumada, Seiki Kiriyama, Yasuhiro Sone, Makoto Tanikawa, Yasuhiro Hisanaga, Hidenori Toyoda, Hiroki Kawashima, Akihiro Itoh, Yoshiki Hirooka, Hidemi Goto
Akira Kanamori, Takashi Kumada, Seiki Kiriyama, Yasuhiro Sone, Makoto Tanikawa, Yasuhiro Hisanaga, Hidenori Toyoda, Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki 503-8502, Japan
Hiroki Kawashima, Akihiro Itoh, Hidemi Goto, Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan
Yoshiki Hirooka, Hidemi Goto, Department of Endoscopy, Nagoya University Hospital, Nagoya 466-8560, Japan
Author contributions: All authors contributed equally to this work; Akira Kanamori wrote the paper.
Correspondence to: Akira Kanamori, Department of Gastroenterology, 4-86 minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan. tkumada@he.mirai.ne.jp
Telephone: +81-584-813341
Fax: +81-584-755715
Received: October 22, 2008
Revised: January 8, 2009
Accepted: January 15, 2009
Published online: March 7, 2009
Abstract

Tumors of the minor papilla of the duodenum are quite rare. We successfully and safely treated an 18-mm adenoma of the minor papilla associated with pancreas divisum using endoscopic papillectomy. A 64-year-old man was admitted to our hospital for treatment of an asymptomatic mass in the minor papilla detected by upper gastrointestinal endoscopy. Endscopic analysis showed an 18-mm, whitish, sessile mass, located in the duodenum proximal to a normal-appearing major papilla. Endoscopic retrograde pancreatography did not reveal the pancreatic duct. Magnetic resonance cholangiopancreatography showed a lack of the ventral pancreatic duct. We suspected this case was associated with pancreatic divisum; therefore, we performed endoscopic papillectomy of the minor papilla tumor. Subsequently, endoscopic pancreatic stent placement in the minor papilla was done to prevent drainage disturbance. The patient has been asymptomatic without recurrence of tumor or stenosis of the Santorini orifice upon endoscopic examination for the past 2 years.

Keywords: Endscopic papillectomy; Minor papillar adenoma; Pancreas divisum; Endoscopic pancreatic stent; Endoscopic retrograde pancreatography