Ampullary Carcinoma Clinical Presentation

Updated: Nov 10, 2016
  • Author: Ayana Allard-Picou, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Presentation

History

The most common clinical manifestation of ampullary carcinoma is jaundice, which occurs due to obstruction of the biliary tract by the tumor. Patients may also experience scleral icterus and pruritus because of obstruction of the bile duct. Other common complaints include dyspepsia, anorexia, malaise, and weight loss.

Pancreatitis may sometimes be the initial clinical presentation due to pancreatic duct obstruction. Patients may therefore complain of symptoms of pancreatitis, such as epigastric/mid-abdominal pain, back pain, nausea, and vomiting.

Diarrhea, a common but not universal symptom, might be associated with an absence of lipase within the gut because of pancreatic duct obstruction.

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Physical

See the list below:

  • Physical examination sometimes reveals a Courvoisier’s sign (ie, a distended, palpable gallbladder in a patient with jaundice).
  • Fever can be present, particularly when the biliary tract has been explored previously (eg, after common duct exploration for stones, or after endoscopic retrograde cholangiopancreatography [ERCP]).
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