Korean J Gastroenterol.  2024 Sep;84(3):138-141. 10.4166/kjg.2024.078.

Ectopic Opening of the Common Bile Duct Accompanied by Duodenal Ulcer

• Noh JH

• KMID: 2559848
• DOI: http://doi.org/10.4166/kjg.2024.078

Figure

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  Fig. 1 MRCP findings. (A) Hook-shaped angulation and narrowing of the distal common bile duct (CBD) leading to dilation of both intrahepatic and extrahepatic bile ducts as well as the main pancreatic duct. (B) Ectopic insertion of the CBD and pancreatic duct into the duodenal bulb.

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  Fig. 2 Esophagogastroduodenoscopy findings. (A) The pylorus and duodenal bulb show stenosis and deformation but the endoscope passes without resistance. (B) Acute ulcer with surrounding erythema and edema in the superior duodenal angle. (C) Suspicious ectopic opening adjacent to the duodenal ulcer. (D) Ectopic opening with surrounding brownish liquid suspected to be bile.

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  Fig. 3 ERCP findings. (A) A catheter is inserted through the opening in the duodenal bulb. (B) Contrast injection through the catheter reveals a diffusely dilated CBD from the opening entrance. ERCP, endoscopic retrograde cholangiopancreatography; CBD, common bile duct.

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