Duodenal stenosis associated with an ectopic opening of the common bile duct into the duodenal bulb: a case report

Abstract

Background Ectopic opening of the common bile duct is a rare congenital biliary anomaly. Herein, we present a case of duodenal stenosis with ectopic opening of the common bile duct into the duodenal bulb. Case presentation A 54-year-old man was referred with fever, nausea, and vomiting. He had experienced epigastric pain several times over the past 30 years. Endoscopy showed a post-bulbar ulcer, a submucosal tumor of the duodenum, and a small opening with bile secretion. Contrast duodenography revealed duodenal stenosis and bile reflux with a common bile duct deformity. Pancreatoduodenectomy was performed because of the clinical suspicion of a biliary neoplasm or groove pancreatitis. The resected specimen showed an ectopic opening of the common bile duct into the duodenal bulb and no tumor. Conclusions Ectopic opening of the common bile duct into the duodenal bulb is complicated by a duodenal ulcer, deformity, and stenosis mimicking groove pancreatitis or pancreatic tumors. Although rare, we should be aware of this anomaly for an accurate diagnosis.

Ectopic bile duct: A case report and brief review

“…Stone extraction is commonly performed via papillary balloon dilatation for choledocholithiasis, but stenting preferred in comorbid and/or elderly patients [4]. This seemed to be a safer alternative to sphincterotomy, which is limited by higher rates of perforation and bleeding [4,11]. As EAVs are J Case Rep Images Surg 2023;9(2):7-11. www.ijcrisurgery.com associated with dilated biliary tree, angulated hookshaped CBD and distorted duodenum, the complexity of ERCPs are amplified [1,8].…”