Korean J Gastrointest Endosc.  2008 Dec;37(6):459-463.

A Case of an Anomalous Opening of the Common Bile Duct and Pancreatic Duct into the Duodenal Bulb, and the Patient Presented with Acute Cholangitis and Recurrent Duodenal Ulcer

• Cho MJ
• Oh MN
• Baek HK
• Cho KS
• Kang JH
• Lee YJ
• Kim JW
• Cho JW

Abstract

There are various congenital anomalies of the biliary system, but an ectopic opening of the common bile duct into the duodenal bulb is an extremely rare finding. Despite the recent improvement in the diagnosis and management of pancreatobiliary lesions, the general lack of knowledge and understanding about these variations is undoubtedly responsible for many of the problems that occur during the medical and surgical management of these lesions. We report here on a case of a 65-year-old man who had an ectopic opening of the common bile duct into the duodenal bulb, and this cause acute cholangitis with bile duct sludge, and also recurrent duodenal ulcer. In this case, we used abdomen CT, MRCP, duodenoscopy, EUS and ERCP for making the diagnosis. The cholangitis and duodenal ulcer was improved with medical therapy, and the patient was discharged without any surgical procedure. We report here on this unusual case and we include a review of the relevant medical literature.

Keyword

Anomalous drainage; Common bile duct; Duodenal bulb; Acute cholangitis; Duodenal ulcer

MeSH Terms

Abdomen
Aged
Bile Ducts
Biliary Tract
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis
Common Bile Duct
Duodenal Ulcer
Duodenoscopy
Humans
Pancreatic Ducts
Sewage
Sewage