Microcholedocholithiasis in a patient with an anomaly of the pancreatobiliary maljunction

Abstract

To date, the diagnosis of both microcholedocholithiasis and anomalies of the pancreatobiliary maljunction is a difficult task. It is the improvement of the diagnostic algorithm for this category of patients that allows us to start timely treatment. In this clinical case, the diagnosis of microcholedocholithiasis and anomalies of the pancreatobiliary maljunction is described, which is extremely rare and causes difficulties in making a diagnosis and choosing a treatment strategy. The aim: to determine the information content of various types of research in the diagnosis of microcholedocholithiasis in anomalies of the pancreatobiliary fistula. Materials and methods: in the GKB im. S. P. Botkin received a patient with severe pain in the upper abdomen, weakness. In the emergency room, the patient underwent a complete blood count, biochemical blood test and transabdominal ultrasound, after transfer to the surgical department, MSCT and EUS were performed. Results: according to the results of EUS, it was revealed in the patient that the pancreatic duct opens into the common bile duct at a distance of 15 mm from the OBD zone, and calculi with a diameter of up to 2 mm were detected in the terminal bile duct. At the same time, the patient underwent retrograde transpapillary intervention with papillotomy and removal of the calculus. Conclusions: the combination of microcholedocholithiasis and anomalies of the pancreatobiliary maljunction is an extremely rare pathology. The use of a comprehensive therapeutic and diagnostic approach makes it possible to detect an anomaly of the pancreatobiliary maljunction and calculi with a diameter of 2 mm in the bile duct, which makes it possible to reasonably and timely perform surgical treatment avoiding the development of serious complications.