A Case of Acute Recurrent Pancreatitis Caused by Branch Duct Type IPMN and Ampulla of Vater Adenoma with High Grade Dysplasia

Acute pancreatitis is an inflammatory disease that can extend to extra-pancreatic tissues and distant organs. Detecting the underlying cause is important because it helps provide an appropriate treatment plan and improve prognosis. An underlying cause cannot be identified after initial evaluation in 10-30% of patients with acute pancreatitis, and they are diagnosed with idiopathic acute pancreatitis. Here, we report a case of a 77-year-old woman with acute recurrent pancreatitis caused by a branch duct-type intraductal papillary mucinous neoplasm (IPMN) and an ampulla of Vater adenoma. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed only IPMN. However, endoscopic retrograde cholangiopancreatography revealed a mucosal abnormality of the ampulla of Vater. The mucosal abnormality was documented to be an ampulla of Vater adenoma with high-grade dysplasia. (Korean J Med 2014;87:579-584)