Duplication of the Extrahepatic Bile Duct in Association with Choledocholithiasis as Depicted by MDCT

Article · December 2008with31 Reads
DOI: 10.3348/kjr.2008.9.6.550 · Source: PubMed
Abstract
We report here on an extremely rare case of duplicated extrahepatic bile ducts that was associated with choledocholithiasis, and this malady was visualized by employing the minimum intensity projection images with using multi-detector row CT. The presence of duplicated extrahepatic bile ducts with a proximal communication, and the ducts were joined distally and they subsequently formed a single common bile duct, has not been previously reported.
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    • The presence of double bile duct is a normal step during early human embryogenesis; however, this primitive duplicated system regresses to give rise to the conventional anatomy consisting of a single common bile duct. The development of DCBD can be ascribed to disturbances in recanalization of the hepatic primordium as well as coalescence of vacuoles of the primitive biliary duct, which has two lumens initially [7,8]. The earliest classification of DCBD was proposed by Goor and Ebert (1972) based on the anatomical appearance.
    [Show abstract] [Hide abstract] ABSTRACT: Double common bile duct (DCBD) is a rare congenital anomaly. Most of these bile duct anomalies are associated with bile duct stones, anomalous pancreaticobiliary junction (APBJ), pancreatitis and bile duct or gastric cancers. Early detection and treatment is important to avoid long term complications. Surgical resection of the anomalous bile duct and reconstruction of the biliary enteric anastomosis is the treatment of choice. We report a rare case of DCBD anomaly in a girl, who presented with recurrent cholangitis. She had type Va DCBD anomaly. She underwent successful resection of the bile duct and reconstruction of the biliary enteric anastomosis. Preoperative imaging and diagnosis of the congenital biliary anomaly is very important to avoid intraoperative bile duct injury. Review of the literature shows very few cases of type Va DCBD, presenting with either bile duct stones or APBJ.
    Full-text · Article · Oct 2015
    • [7] Another important feature of the bile duct development is rotation of the primitive duodenum along its longer axis, which brings the duct superior to the second part of the duodenum.The anomalies can be ascribed to disturbances in recanalization of the hepatic primordium as well as coalescence of vacuoles of the primitive biliary duct, which has two lumens initially. [4] The earliest classification of double common bile duct (DCBD) was proposed by Goor and Ebert (1972) based on the anatomical appearance. The latest one is proposed by Choi et al. (2007) based on morphology, which adds on a new type V variant to the existing classification proposed by Saito et al. (1988).
    [Show abstract] [Hide abstract] ABSTRACT: Congenital duplication of the common bile duct is an extremely rare anomaly of the biliary tract, which putatively represents failure of regression of the embryological double biliary system. Depending on the morphology of the duplicated bile duct, the anomaly can be classified into five distinct subtypes as per the modified classification (proposed by Choi et al). Among the five subtypes of bile duct duplication, type V duplication is considered to be the least common with only two previous cases of type Va variant reported in medical literature prior to the current report.
    Full-text · Article · Feb 2015
  • [Show abstract] [Hide abstract] ABSTRACT: We present the case of a 60-year-old woman admitted to hospital with acute abdominal pain on a background history of vague dyspeptic symptoms managed as an outpatient. Serial imaging investigation with a barium contrast meal, oesophagogastroduodenoscopy, ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography (MRCP) established a very rare diagnosis. Our patient had extrahepatic bile duct duplication with an accessory bile duct draining the left lobe of the liver into the antrum of the stomach without intrahepatic communication of the left and right bile duct systems, complicated by choledocholithiasis of the accessory duct. Diagnosis of this variant was finally made with MRCP at 2 months follow-up to the initial admission, which also demonstrated spontaneous passage of the accessory duct stone. A differential diagnosis list for cystic structures in the lesser omentum is considered. We believe that this is the first such case to be demonstrated with all 6 forms of imaging described, which were performed, undoubtedly, because of its rarity. Retaining awareness of such rare anomalies in our clinical practice should lead to appropriate imaging being initiated early and avoid delay in diagnosis, especially because of associations with potentially serious complications.
    Article · Jul 2010
  • [Show abstract] [Hide abstract] ABSTRACT: A 72-year-old hypertensive woman presented with a 2-month history of right upper quadrant abdominal pain. She had a 15-day history of jaundice, fever with chills and shivering, nausea, vomiting, weight loss and generalized pruritus. Physical examination, laboratory evaluation, transabdominal ultrasonography, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, brush cytology, laparotomy and histopathology. Bile duct duplication with coexistence of distal cholangiocarcinoma. En bloc resection (including the duodenum, pancreatic head and adjacent lymph nodes), hepaticojejunostomy and pylorus-saving Whipple operation.
    Article · Sep 2010
  • [Show abstract] [Hide abstract] ABSTRACT: Duplication of the extrahepatic bile duct is an extremely rare anomaly. There are five types of this anomaly, with type V being the least common variant. Only two cases of type V (one each of type Va and type Vb) have been reported. Here we report the second case of type Va duplication of the common bile duct presenting with choledocholithiasis. The patient underwent open choledocholithotomy and T-tube choledochostomy after failed endoscopic stone clearance. Duplication of the bile duct was detected on T-tube cholangiogram, which was confirmed by magnetic resonance cholangiopancreaticography (MRCP). No associated pancreaticobiliary maljunction was found on the imaging.
    Article · Sep 2012
  • [Show abstract] [Hide abstract] ABSTRACT: Double common bile duct (DCBD) is a rare congenital anomaly of the biliary system, often associated with biliary lithiasis, choledochal cyst, pancreaticobiliary maljunction (PBM), and upper gastrointestinal tract malignancies. We report a case of type I DCBD with choledochal cyst and cholelithiasis in a 52-year-old Chinese man. We also reviewed 24 cases of DCBD reported in the Chinese literature between 1965 and 2012. Most (58.3 %) of these cases were classified as type I DCBD, with accompanying choledocholithiasis in 79.2 %, cholecystolithiasis in 37.5 %, choledochal cyst in 33.3 %, and PBM in 8.3 %. There was no case of concomitant cancer. The type and coexistence of PBM with DCBD are clinically important because of its close implications with concomitant pathology. Most Chinese people with DCBD have type I. Moreover, the high incidences of choledochal cyst and biliary lithiasis and the extremely low incidences of PBM and biliary cancer are the major clinical characteristics of DCBD in China.
    Article · Apr 2013
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