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| Amiodarone hepatotoxicity complicating obstructive jaundice due to ampullary cancer |
| Anne M Collins, Des C Winter, Aidan P McCormick, David C Cottell and Justin G Geoghegan |
Dublin, Ireland
Author Affiliations: Department of Surgery and Hepatology, St. Vincent’s University Hospital, Dublin 4, Ireland (Collins AM, Winter DC, McCormick AP and Geoghegan JG); Electron Microscopy Laboratory, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland (Cottell DC)
Corresponding Author: Des C Winter, Consultant General and Colorectal Surgeon, St. Vincent’s University Hospital, Dublin 4, Ireland (Tel: +363-1-2695033; Email: winterd@indigo.ie) |
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Abstract 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 identified an ampullary adenoma. However, the endoscopic ultrasound and intra-operative findings suggested a malignancy, which was confirmed postoperatively.
CONCLUSIONS: While the classic findings 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.
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2007, Vol. 6 
