Korean J Gastroenterol.  2021 Dec;78(6):359-361. 10.4166/kjg.2021.162.

Double Duodenal Major Papilla

• Kang H

• KMID: 2523599
• DOI: http://doi.org/10.4166/kjg.2021.162

Abstract

no abstract available.

Figure

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  Fig. 1 Axial and transverse view of portal phase abdominal computed tomography. (A) The axial view shows dilated bile duct and cystic duct due to common bile duct stricture. (B) The transverse view shows enhancing lesion (between white triangles) causing biliary stricture at the upper border of intrapancreatic common bile duct.

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  Fig. 2 Endoscopic view of double duodenal major papilla. (A) Two adjacent elevated structures were noted in duodenal second portion. The proximal papilla (white triangle) faces proximal side of duodenum, while the distal papilla (black triangle) lies parallelly on the duodenal wall like an ordinary major papilla. (B) Short-range view shows similar size and appearance with “fronding” pattern and central orifice in both duodenal major papillas.

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  Fig. 3 Fluoroscopic image. (A) Cholangiogram shows short segmental stricture of common bile duct just below the cystic duct union. No communication between bile duct and pancreatic duct, or between both major papilla orifices is seen. (B) Through the distal papilla, guidewire could be advanced to pancreatic duct only.

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  Fig. 4 Uncovered self-expanding metal stent is placed in bile duct through the proximal papilla, while single-pigtail plastic stent is placed in pancreatic duct through the distal papilla.

Reference

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