Four cases of distal common bile duct polyps causing abdominal pain, jaundice, cholangitis, and acute pancreatitis

Abstract

We have come across four cases presented to us with a history of abdominal pain, jaundice, cholangitis, and acute pancreatitis. On investigating, we found that all had distal common bile duct (CBD) polyps or polypoidal lesions causing these symptoms. All were subjected to endoscopic ultrasound and then endoscopic retrograde cholangiopancreatography. Papillotomy was done, the polyps brought out of the CBD with a balloon or a basket and then snared off, and CBD and PD stents were placed. The histopathology showed adenomatous polyps with low-grade dysplasia in three cases and adenofibroma/hamartomatous polyp in one. One patient was found to have underlying malignancy after 2 months.Conclusion:Distal CBD polyps though not a common occurrence are seen in clinical practice and can cause abdominal pain, jaundice, cholangitis, and acute pancreatitis.