Abstract
BackgroundEctopic opening of the common bile duct is a rare congenital biliary anomaly. Herein, we present a case of duodenal stenosis with ectopic opening of the common bile duct into the duodenal bulb.Case presentationA 54-year-old man was referred with fever, nausea, and vomiting. He had experienced epigastric pain several times over the past 30 years. Endoscopy showed a post-bulbar ulcer, a submucosal tumor of the duodenum, and a small opening with bile secretion. Contrast duodenography revealed duodenal stenosis and bile reflux with a common bile duct deformity. Pancreatoduodenectomy was performed because of the clinical suspicion of a biliary neoplasm or groove pancreatitis. The resected specimen showed an ectopic opening of the common bile duct into the duodenal bulb and no tumor.ConclusionsEctopic opening of the common bile duct into the duodenal bulb is complicated by a duodenal ulcer, deformity, and stenosis mimicking groove pancreatitis or pancreatic tumors. Although rare, we should be aware of this anomaly for an accurate diagnosis.
Highlights
Ectopic opening of the common bile duct is a rare congenital biliary anomaly
Ectopic opening of the common bile duct into the duodenal bulb is complicated by a duodenal ulcer, deformity, and stenosis mimicking groove pancreatitis or pancreatic tumors
Various opening sites have been described in the literature of the ectopic opening of the common bile duct (EOCBD), such as the 3rd or 4th portion of the duodenum, pyloric canal, duodenal bulb, and stomach
Summary
EOCBD into the duodenal bulb may be associated with biliary and duodenal diseases, such as recurrent duodenal ulcers. EOCBD into the duodenal bulb should be considered in patients with recurrent duodenal ulcers and duodenal stenosis. BB bilioenteric bypass, PD pancreaticoduodenectomy, – not mentioned about it Abbreviations EOCBD: Ectopic opening of common bile duct; CT: Computed tomography; ERCP: Endoscopic retrograde cholangiopancreatography; FDG: Fluorodeoxyglucose; BB: Bilioenteric bypass; PD: Pancreaticoduodenectomy
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