Abstract
A 16-year-old girl visited our institution because of recurrent acute pancreatitis. MRCP showed a clearly normal pancreaticobiliary duct without dilatation or maljunction, and no biliary stones (A). A bulging of the ampullary region proximal to the papilla was noted on endoscopic view (B). EUS revealed a well-defined isoechoic solid nodule with hyperechoic spots, measuring 9.5 × 8.8 mm over the bulge, without biliary dilatation or cyst (C). In addition, cholecystitis was confirmed. For making a definite diagnosis of the periampullary bulge, ERCP was performed.
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