Choledochocele with pancreas divisum: A rare co-occurrence diagnosed on magnetic resonance cholangiopancreatography

Abstract

We report a case of a 42-year-old male with symptomatic choledochocele and incidental pancreas divisum diagnosed with magnetic resonance cholangiopancreatography (MRCP). Small choledochocele is rare congenital malformation associated with non-specific symptoms and a delay in diagnosis. The coexistence of choledochocele and pancreas divisum is extremely rare with only two case reports published in literature. In both cases MRCP failed to diagnose any biliary or pancreatic abnormality. This case suggests that the patients with recurrent abdominal pain and pancreas divisum should not be presumed to be suffering from pancreatitis. Careful evaluated for additional anomalies in the biliary tree should be sought for refractory symptoms. MRCP is a useful one-stop-shop for diagnosing pancreatic and biliary ductal anomalies. Core tip: Small choledochocele is a rare congenital malformation associated with non-specific symptoms and a delay in diagnosis. The coexistence of choledochocele and pancreas divisum is extremely rare with only two cases reported in literature. In both cases magnetic resonance cholangiopancreatography (MRCP) failed to diagnose any biliary or pancreatic abnormality. We report a case of a 42-year-old male with symptomatic choledochocele and incidental pancreas divisum diagnosed with MRCP.Patidar Y , Agarwal N, Gupta S, Arora A, Mukund A, Rajesh S. Choledochocele with pancreas divisum: A rare co-occurrence diagnosed on magnetic resonance cholangiopancreatography. World J Radiol 2013; 5(7): 264-266 Available from: URL:

Identification and management of pancreas divisum

“…Prior studies suggested that there is about a 30–38% co-existence between the two conditions[21, 22, 23] but a recent larger study suggested the prevalence is as high as 50%[24]. There have reports scattered in the literature with PD co-existing with anomalous pancreatic-biliary junction (APBJ) and choledochal cysts[25, 26, 27, 28, 29]. However, there have been no large-scale studies to support any specific associations between these congenital anomalies.…”

Ectopic Opening of the Common Bile Duct Accompanied by Choledochocele and Pancreas Divisum

“…To our knowledge, this is the first report of an ectopic opening of the CBD into the duodenal bulb accompanied by choledochocele and PD (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Choledochocele concomitant with PD is also rare, with only three case reports having been published (25)(26)(27); therefore, our case is extremely rare.…”