Ampullary carcinoma in a patient with agenesis of the dorsal
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A 42-year-old male patient, with a known case of diabetes mellitus since childhood, presented with painless progressive jaundice, clay-colored stool, and itching for a month. There was no contributory family history. Physical examination revealed jaundice and a palpable gallbladder. Liver function tests showed serum bilirubin of 9 mg/dl and alkaline phosphatase of 360 IU/l. Computed tomography (CT) scan of the abdomen revealed resectable periampullary tumor with dilated bile duct and bulky head of the pancreas; the pancreatic duct was not seen. Body and tail of the pancreas was not visualized on the CT scan. Patient was planned for Whipple’s procedure. On exploration, there was a large resectable ampullary tumor with a bulky head of the pancreas. The body and tail of the pancreas was absent, distal to the superior mesenteric vein...

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