Pancreaticoduodenectomy in the presence of Riedel lobe with accessory extrahepatic bile duct

Abstract

A 32-year-old female trisomy 21 patient presented with upper abdominal pain due to chronic pancreatitis. Gallstone pancreatitis was unlikely after laparoscopic cholecystectomy. Instead, a 3-cm cystic lesion was discovered in the pancreatic head with endosonographic morphology suspicious for intraductal papillary mucinous neoplasm. Due to the presence of worrisome features, especially pancreatitis and the associated abdominal pain, pancreaticoduodenectomy was indicated. In the preoperative computed tomography (CT), a tongue-like caudal projection from the right liver lobe was discovered (Figure 1).