Abstract

BackgroundExtrahepatic bile duct duplication is an extremely rare congenital anomaly in which two common bile ducts exist. There are five different types of this anomaly and we present an unusual variant of duplication of an extrahepatic biliary system of type Va variety.Case presentationThis case report describes a 63-year-old women from rural Nepal who presented with type Va of duplicated extrahepatic bile duct, with chronic calculous cholecystitis and choledocholithiasis. She was managed with cholecystectomy with hepatic ductoplasty and hepaticojejunostomy.ConclusionA rare case of double common bile duct (type Va) complicated by choledocholithiasis, cholangitis, and chronic cholecystitis is reported here. Rare cases are sometimes overlooked by modern diagnostic techniques. Correct diagnosis helps appropriate surgical intervention.

Highlights

  • BackgroundDuplication of the extrahepatic bile duct is one of the rarest congenital variants. The first description of this anomaly was done by Vesalius in 1543 [1]

  • Extrahepatic bile duct duplication is an extremely rare congenital anomaly in which two common bile ducts exist

  • We present a case of duplication of the extrahepatic bile duct (Type Va) along with cholelithiasis and choledocholithiasis

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Summary

Background

Duplication of the extrahepatic bile duct is one of the rarest congenital variants. The first description of this anomaly was done by Vesalius in 1543 [1]. We present a case of duplication of the extrahepatic bile duct (Type Va) along with cholelithiasis and choledocholithiasis. Case presentation A 63-year-old woman from rural Nepal presented with a history of right upper abdominal pain, epigastric discomfort, bloating, and dyspepsia for 4 years, followed by intermittent fever and jaundice for a month. She had an increase in severity of pain, yellowish discoloration of body, vomiting, and fever for 1 week but had no history of anorexia or weight loss. After closing distal common bile duct stump, reconstruction was done by hepatic ductoplasty (joining two ducts) with hepaticojejunostomy in Roux-en-Y fashion. Histologic examination of the resected specimens revealed chronic inflammatory changes in the gallbladder and common bile duct with no evidence of malignancy

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