{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:06:02Z","timestamp":1753877162189,"version":"3.41.2"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Ampulla of Vater (AOV) is typically located in the second part of the duodenum. There are few reported cases of ectopic AOV over the line extending from the pylorus of the stomach down to the distal part of the duodenum. However, to the best of our knowledge, there are only five cases reported in the English literature of an ectopic AOV in the fourth part of the duodenum, with only one of them having adenocarcinoma of the ampulla. Hereby, we report the first case of ectopic AOV in the fourth part of the duodenum, presenting with obstructive due to adenocarcinoma with focal squamous differentiation. This is the case a 42-year-old lady who had a sleeve gastrectomy for morbid obesity in the past. She presented with right upper quadrant pain for one month associated with subjective fever, unintentional weight loss, pale stool, and dark urine. The physical examination revealed a deeply jaundiced lady with an unremarkable abdominal exam. A computed tomography scan of the abdomen revealed intrahepatic and extrahepatic biliary dilation with ectopic insertion of the distal CBD into the fourth part of the duodenum with no evidence of biliary stones. She underwent pancreaticoduodenectomy after difficult biliary decompression. Histopathological diagnosis was moderately differentiated adenocarcinoma, pancreaticobiliary type with focal squamous differentiation. Ectopic AOV is a very rare entity, especially when it is associated with adenosquamous carcinoma changes.<\/jats:p>","DOI":"10.1093\/jscr\/rjae377","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T17:22:11Z","timestamp":1717435331000},"source":"Crossref","is-referenced-by-count":0,"title":["Ectopic ampulla of vater in D4 with adenosquamous carcinoma: case report and literature review"],"prefix":"10.1093","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7808-0623","authenticated-orcid":false,"given":"Mohammed Abdulmohsen","family":"AlSharit","sequence":"first","affiliation":[{"name":"College of Medicine, Imam Abdulrahman Bin Faisal University , Khobar , Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reem Mohammed","family":"Althwanay","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Abdulrahman Bin Faisal University , Khobar , Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah Saleh","family":"AlQattan","sequence":"additional","affiliation":[{"name":"Department of Surgery, King Fahad Specialist Hospital , Dammam , Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulrahman Abdullah","family":"AlTamimi","sequence":"additional","affiliation":[{"name":"Department of Surgery, King Fahad Specialist Hospital , Dammam , Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabeel","family":"Mansi","sequence":"additional","affiliation":[{"name":"Department of Surgery, King Fahad Specialist Hospital , Dammam , Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"2024071008514710300_ref1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.32074\/1591-951X-709","article-title":"Congenital anomalies of the gastrointestinal tract: the liver, extrahepatic biliary tree and pancreas","volume":"114","author":"Ludwig","year":"2022","journal-title":"Pathologica"},{"key":"2024071008514710300_ref2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1471-230X-10-2","article-title":"The clinical presentations of ectopic biliary drainage into duodenal bulbus and stomach with a thorough review of the current literature","volume":"10","author":"Saritas","year":"2010","journal-title":"BMC Gastroenterol"},{"key":"2024071008514710300_ref3","doi-asserted-by":"crossref","first-page":"3379","DOI":"10.12998\/wjcc.v9.i14.3379","article-title":"Acute cholangitis detected ectopic ampulla of Vater in the antrum incidentally: a case report","volume":"9","author":"Lee","year":"2021","journal-title":"World J Clin Cases"},{"key":"2024071008514710300_ref4","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1053\/jpsu.2001.27932","article-title":"Ectopic distal location of the papilla of Vater in congenital biliary dilatation: implications for pathogenesis","volume":"36","author":"Li","year":"2001","journal-title":"J Pediatr Surg"},{"key":"2024071008514710300_ref5","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1007\/s00383-002-0914-0","article-title":"Anomalous pancreatic duct anatomy, ectopic distal location of the papilla of Vater and congenital biliary dilatation: a new developmental triad?","volume":"19","author":"Li","year":"2003","journal-title":"Pediatr Surg Int"},{"key":"2024071008514710300_ref6","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1186\/1477-7819-11-124","article-title":"Adenosquamous carcinoma of the ampulla of vater - a rare disease at unusual location","volume":"11","author":"Yang","year":"2013","journal-title":"World J Surg Oncol"},{"key":"2024071008514710300_ref7","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1186\/s12957-015-0709-0","article-title":"Adenosquamous carcinoma of the ampulla of vater: a case report and literature review","volume":"13","author":"Hoshimoto","year":"2015","journal-title":"World J Surg Oncol"},{"key":"2024071008514710300_ref8","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1471-230X-7-26","article-title":"Anomalous opening of the common bile duct into the duodenal bulb: endoscopic treatment","volume":"7","author":"Disibeyaz","year":"2007","journal-title":"BMC Gastroenterol"},{"key":"2024071008514710300_ref9","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1067\/mge.2003.210","article-title":"Ectopic opening of the common bile duct in the duodenal bulb: clinical implications","volume":"57","author":"Lee","year":"2003","journal-title":"Gastrointest Endosc"},{"key":"2024071008514710300_ref10","doi-asserted-by":"crossref","first-page":"517","DOI":"10.2214\/ajr.169.2.9242767","article-title":"ERCP and CT findings of ectopic drainage of the common bile duct into the duodenal bulb","volume":"169","author":"Lee","year":"1997","journal-title":"Am J Roentgenol"},{"key":"2024071008514710300_ref11","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.ijscr.2022.106887","article-title":"Ectopic papilla of vater in the pylorus presenting with cholangitis: a case report with literature review","volume":"93","author":"Alkarboly","year":"2022","journal-title":"Int J Surg Case Rep"},{"key":"2024071008514710300_ref12","doi-asserted-by":"crossref","first-page":"70","DOI":"10.28982\/josam.843063","article-title":"Comparison of the procedure results of ectopic papillae encountered during ERCP procedure with the procedure results of papillae with normal localization","volume":"5","author":"Balli","year":"2021","journal-title":"J Surg Med"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2024\/6\/rjae377\/58333891\/rjae377.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2024\/6\/rjae377\/58333891\/rjae377.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T08:59:37Z","timestamp":1720601977000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjae377\/7686803"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,3]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjae377","relation":{},"ISSN":["2042-8812"],"issn-type":[{"type":"electronic","value":"2042-8812"}],"subject":[],"published-other":{"date-parts":[[2024,6]]},"published":{"date-parts":[[2024,6]]},"article-number":"rjae377"}}