Villous adenoma of the ampulla of Vater. An unusual cause of biliary colic and obstructive jaundice.

An unusual case of biliary obstruction caused by a benign villous adenoma of the ampulla of Vater is reported and the literature reviewed. Of the reported cases, 75% have jaundice or symptoms of cholecystitis. Rarely, gastrointestinal bleeding or pancreatic duct obstruction is a presenting symptom. The tumors are frequently small and can be overlooked. Operative treatment varies from excision of the tumor to pancreatoduodenal resection depending on histological evaluation, intraoperative findings, and the surgeon's philosophy.