Amiodarone hepatotoxicity complicating obstructive jaundice due to ampullary cancer

摘要

BACKGROUND:The presence of dual pathology can cause diagnostic dilemmas. We present a case of adenocarcinoma of the ampulla of Vater with concurrent amiodarone hepatotoxicity. METHODS: Painless jaundice associated with a palpable gallbladder was investigated clinically, radiologically, endoscopically and via liver biopsy. RESULTS:Liver biopsy showed amiodarone hepatotoxicity. Endoscopic biopsy identiifed an ampullary adenoma. However, the endoscopic ultrasound and intra-operative ifndings suggested a malignancy, which was conifrmed postoperatively. CONCLUSIONS:While the classic ifndings of Courvoisier's Law are borne out in this case, the etiology of jaundice is twofold. Although dual pathology is uncommon it should always be considered.