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• W2056317076 abstract "A 51-year-old woman with NF1 and history of cholecystectomy was referred for investigation of persistent ferropenic anemia. Gynecologic examination and upper-lower endoscopy were normal. Anti-endomysial and anti-transglutaminase antibodies were also negative. Abdominal computed tomography scan showed mild dilation (10 mm) of the common bile duct. Capsule endoscopy revealed active bleeding in the second part of the duodenum, but it did not identify the bleeding source. Examination with a duodenoscope showed an ulcerated submucosal ampullary tumor with active bleeding (Figure A). Endoscopic sphincterotomy was performed, and multiple biopsies were taken. Histologic analysis revealed infiltration of lamina propria and muscularis mucosa with carcinoid cells that were strongly positive for synaptophysin (Figure B). A biochemical panel after sphincterotomy, including liver function tests, serum serotonin, pancreatic polypeptide, serum gastrin, and 24-hour urine 5-hydroxyindoleacetic acid levels, was within normal limits. Although the tumor was smaller than 2 cm, the patient underwent Whipple procedure because this is the most appropriate treatment for ampullary carcinoids. Ampullary carcinoids present with painless jaundice, abdominal pain, bleeding, and rarely with gastrointestinal obstruction and carcinoid syndrome.1Mayoral W. Salcedo J. Al-Kawas F. Ampullary carcinoid tumor presenting as acute pancreatitis in a patient with von Recklinghausen’s disease: case report and review of the literature.Endoscopy. 2003; 35: 854-857Google Scholar Duodenoscopy with side-viewing endoscope appears to be the most helpful diagnostic examination for the diagnosis of ampullary carcinoids.1Mayoral W. Salcedo J. Al-Kawas F. Ampullary carcinoid tumor presenting as acute pancreatitis in a patient with von Recklinghausen’s disease: case report and review of the literature.Endoscopy. 2003; 35: 854-857Google Scholar, 3Levy A.D. Taylor L.D. Abbott R.M. et al.Duodenal carcinoids: imaging features with clinical-pathologic comparison.Radiology. 2005; 237: 967-972Google Scholar A 51-year-old woman with NF1 and history of cholecystectomy was referred for investigation of persistent ferropenic anemia. Gynecologic examination and upper-lower endoscopy were normal. Anti-endomysial and anti-transglutaminase antibodies were also negative. Abdominal computed tomography scan showed mild dilation (10 mm) of the common bile duct. Capsule endoscopy revealed active bleeding in the second part of the duodenum, but it did not identify the bleeding source. Examination with a duodenoscope showed an ulcerated submucosal ampullary tumor with active bleeding (Figure A). Endoscopic sphincterotomy was performed, and multiple biopsies were taken. Histologic analysis revealed infiltration of lamina propria and muscularis mucosa with carcinoid cells that were strongly positive for synaptophysin (Figure B). A biochemical panel after sphincterotomy, including liver function tests, serum serotonin, pancreatic polypeptide, serum gastrin, and 24-hour urine 5-hydroxyindoleacetic acid levels, was within normal limits. Although the tumor was smaller than 2 cm, the patient underwent Whipple procedure because this is the most appropriate treatment for ampullary carcinoids. Ampullary carcinoids present with painless jaundice, abdominal pain, bleeding, and rarely with gastrointestinal obstruction and carcinoid syndrome.1Mayoral W. Salcedo J. Al-Kawas F. Ampullary carcinoid tumor presenting as acute pancreatitis in a patient with von Recklinghausen’s disease: case report and review of the literature.Endoscopy. 2003; 35: 854-857Google Scholar Duodenoscopy with side-viewing endoscope appears to be the most helpful diagnostic examination for the diagnosis of ampullary carcinoids.1Mayoral W. Salcedo J. Al-Kawas F. Ampullary carcinoid tumor presenting as acute pancreatitis in a patient with von Recklinghausen’s disease: case report and review of the literature.Endoscopy. 2003; 35: 854-857Google Scholar, 3Levy A.D. Taylor L.D. Abbott R.M. et al.Duodenal carcinoids: imaging features with clinical-pathologic comparison.Radiology. 2005; 237: 967-972Google Scholar" @default.
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• W2056317076 title "An Unusual Case of Obscure Gastrointestinal Bleeding in a Patient With Neurofibromatosis Type 1" @default.
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• W2056317076 doi "https://doi.org/10.1016/j.cgh.2014.10.021" @default.
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