**Abbreviations**

*Gastrointestinal Stomas*

**3.10 Changes in the gallbladder**

*Lithiasis and bladder distension associated with a vaterian ampulloma.*

(**Figure 11**).

**Figure 11.**

neoplasia [1].

ampulla of Vater.

**4. Differential diagnosis**

cholecyst.

In the case of the vaterian ampullomas, changes of the gallbladder can also occur, namely, in volume, wall, as well as the presence of calcifications inside

The changes of the gallbladder are detected by computed tomography or magnetic resonance in 33% of occurrences in the case of the vaterian ampullomas, but without being able to distinguish if they were preexisting or caused by

Comparing to primitive duodenal neoplasms, there are no changes to the

changes in the cholecyst leads the diagnosis to a vaterian ampulloma.

which reduces the list of possible differential diagnoses.

For both diagnoses the role of CT and MRI is defined.

atic neoplasm and duodenal malignancy.

Pancreatic head neoplasm:

It is considered that over 60% of the changes of the gallbladder in the tumor pathology of the duodenopancreatic region are detected in the cases of neoplasms of the ampulla of Vater. This leads to the conclusion that the presence of a gap in the periampullary region associated with changes in the choledochal caliber and with

It is considered that there are no intracholecystic tumor masses and that the presence of vesicular lithiasis predominated in the case of the vaterian ampullomas. In the case of ampullary carcinomas, there is no analysis of the changes of the vessels, due to their nonexistence, taking into account the anatomical reports of the

The vaterian ampulloma is a neoplastic entity with precise diagnostic elements,

By anatomical topography, the only possible differential diagnoses are pancre-

With the help of CT, but especially MRI, it is established from the beginning the location of the tumor mass, the size, the changes in structure, and the contrast of the pancreatic cephalic tumor mass. MRCP contributes to the analysis of changes in the biliary tree and duct of Wirsung, specific to pancreatic cephalic neoplasm.

Diagnostic elements from conventional radiological examination are not practi-

**96**

cally discussed.

