Bulging duodenal papilla
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Major duodenal papilla is a conic or cylindric protuberance at the medial aspect of the descending or horizontal duodenum at the site of the sphincter of of Oddi. It is finding on small bowel follow-though (and endoscopy) and has a relatively long differential.
On cross sectional imaging, the underlying cause is usually seen before the effect on the papilla.
Causes include:
- normal variant
- patulous ampulla of Vater (look for associated pneumobilia)
- tumours
- papillitis
- autoimmune pancreatitis
- choledochocele
- impacted choledocholithiasis
-<p><strong>Major duodenal papilla</strong> is a conic or cylindric protuberance at the medial aspect of the descending or horizontal duodenum at the site of the <a href="/articles/sphincter-of-oddi" title="sphincter of Oddi">sphincter of Oddi</a>. It is finding on small bowel follow-though (and endoscopy) and has a relatively long differential. </p><p>On cross sectional imaging, the underlying cause is usually seen before the effect on the papilla. </p><p>Causes include :</p><ul>- +<p><strong>Major duodenal papilla</strong> is a conic or cylindric protuberance at the medial aspect of the descending or horizontal duodenum at the site of the <a href="/articles/sphincter-of-oddi">sphincter of Oddi</a>. It is finding on small bowel follow-though (and endoscopy) and has a relatively long differential.</p><p>On cross sectional imaging, the underlying cause is usually seen before the effect on the papilla.</p><p>Causes include:</p><ul>
-<li>patulous ampulla of Vater (look for associated <a href="/articles/pneumobilia" title="Pneumobilia">pneumobilia</a>)</li>- +<li>patulous ampulla of Vater (look for associated <a href="/articles/pneumobilia">pneumobilia</a>)</li>
-<li><a href="/articles/intraductal-papillary-mucinous-neoplasm" title="Intraductal papillary mucinous neoplasms (IPMN)">intraductal papillary mucinous neoplasm (IPMN)</a></li>-<li><a href="/articles/ampullary-tumours" title="ampullary tumours">ampullary tumours</a></li>- +<li><a href="/articles/intraductal-papillary-mucinous-neoplasm">intraductal papillary mucinous neoplasm (IPMN)</a></li>
- +<li><a href="/articles/ampullary-tumours">ampullary tumours</a></li>
-<a href="/articles/periampullary-tumours" title="Periampullary tumours">periampullary tumours</a> - <a href="/articles/periampullary-cancer" title="periampullary cancer">periampullary cancer</a>- +<a href="/articles/periampullary-tumours">periampullary tumours</a>: <a href="/articles/periampullary-cancer">periampullary cancer</a>
-<li><a href="/articles/cholangiocarcinoma" title="Cholangiocarcinoma">cholangiocarcinoma</a></li>-<li><a href="/articles/pancreatic-ductal-carcinoma" title="Pancreatic ductal cancer">pancreatic carcinoma</a></li>- +<li><a href="/articles/cholangiocarcinoma">cholangiocarcinoma</a></li>
- +<li><a href="/articles/pancreatic-ductal-adenocarcinoma-2">pancreatic carcinoma</a></li>
-<li><a href="/articles/autoimmune-pancreatitis" title="Autoimmune pancreatitis">autoimmune pancreatitis</a></li>-<li><a href="/articles/choledochocoele" title="choledochocoele">choledochocele</a></li>-<li>impacted <a href="/articles/choledocholithiasis" title="Choledocholithiasis">choledocholithiasis </a>- +<li><a href="/articles/autoimmune-pancreatitis">autoimmune pancreatitis</a></li>
- +<li><a href="/articles/choledochocoele">choledochocele</a></li>
- +<li>impacted <a href="/articles/choledocholithiasis">choledocholithiasis</a>
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