A 55 year old lady had presented with metastatic ampullary tumor causing obstructive jaundice. Endoscopy showed an infiltrated ampulla with a visible bile duct opening (A: white arrow). Ampullary tumors are usually soft and friable and hence offer little hindrance to cannulation. Contrast injection outlined a grossly dilated bile duct (B: white arrows) with a distal stricture. A 10cm long 10 French plastic stent was placed (C1 & C2: white arrows).
