# A Case of Severe Acute Pancreatitis Following Endoscopic Biopsy of the Ampulla of Vater: A Rare Adverse Event of Esophagogastroduodenoscopy

## TL;DR

A rare case of severe acute pancreatitis occurred after an endoscopic biopsy of the ampulla of Vater, highlighting the potential risks of the procedure.

## Contribution

Reports a rare adverse event of acute pancreatitis following ampullary biopsy, emphasizing the need for informed consent and risk assessment.

## Key findings

- A 49-year-old male developed severe acute pancreatitis after an endoscopic biopsy of the ampulla of Vater.
- No other causes for pancreatitis were identified, suggesting the biopsy was the most likely trigger.
- The patient recovered with conservative management and no recurrence was observed after 3 months.

## Abstract

Histological biopsy is essential for diagnosing ampullary tumors; however, it can occasionally result in severe adverse events. A 49‐year‐old male underwent esophagogastroduodenoscopic screening, which revealed an ampulla of Vater with enlargement of the oral protrusion. An endoscopic biopsy was performed; several hours later, the patient developed severe acute pancreatitis requiring hospitalization. The biopsy result was benign, and no gallstones, ductal abnormalities, or other etiologies were identified on endoscopic ultrasonography or magnetic resonance cholangiopancreatography, and the biopsy was considered the most likely trigger. The patient recovered with conservative management and was discharged on day 14. No recurrence has been observed 3 months after discharge. Although acute pancreatitis following biopsy of the ampulla of Vater is extremely rare, it can be fatal. Endoscopists should be aware of this potential risk, carefully assess the necessity of biopsy, and ensure that patients provide informed consent before the procedure.