Ectopic opening of the common bile duct in the duodenal bulb: Clinical implications

Lee, Sang Soo; Kim, Myung–Hwan; Lee, Sung‐Koo; Kim, Kyu-Pyo; Kim, Hong Ja; Bae, Jong Seok; Kim, Hyun Jun; Seo, Dong Wan; Ha, Hyun Kwon; Kim, Jae Seon; Kim, Chang Duk; Chung, Jong-Moon; Min, Young Il

doi:10.1067/mge.2003.210

Cited by 39 publications

(131 citation statements)

References 17 publications

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“…In fact, diseases related with the biliary system are reported frequently in patients with ectopic CBD opening [2][3][4]9,[11][12][13][14][15][16][17][18]. In this study, CBD dilatation was found in 94% of the cases with or without intrahepatic biliary dilatation.…”

Section: Discussionmentioning

confidence: 58%

Aberrant Opening of the Common Bile Duct with Precancerous Change

Kang¹,

Kim²,

Kim³

2018

Korean J Pancreas Biliary Tract

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Section: Discussionmentioning

confidence: 58%

Aberrant Opening of the Common Bile Duct with Precancerous Change

Kang¹,

Kim²,

Kim³

2018

Korean J Pancreas Biliary Tract

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“…In these cases we could not find signs of the papilla in the second duodenal portion or distally. Papilla in the pyloric channel and the duodenum might be related to a congenital malformation with anomalous biliary and pancreatic drainage.In our subjects we observed the diagnostic requirements for an ectopic papilla as described by Lee et al 3 . Criteria for an ectopic location of papilla were:…”

Section: Discussionmentioning

confidence: 98%

“…All of them had recurrent cholangitis, elevated Alkaline phosphatase and one had raised CA 19-9.Their total bilirubin ranged from 4.6 to 9.4 mg/dl, C-reactive protein level was 30 to 190 mg/dL, alanine-aminotransferase 44 to 95 IU/L, leucocytes 15,500 to 18,400/mm 3 and Abdominal ultrasonography showed dilatation of the extrahepatic bile duct with stones, a feature of choledocholithiasis in all three and cholelithiasis in one. History of cholecystectomy was present in 2 of the cases and duodenal ulcer in one.…”

Section: Case Reportmentioning

confidence: 99%

Difficult ERCP with Aberrant Papilla A Report of Three Cases

Perveen¹,

Rahman²,

Hossain

et al. 2018

J. Bangladesh Coll. Phys.

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The ampulla of Vater encompasses the openings of both the common bile duct (CBD) and pancreatic duct (PD). Presently ERCP has allowed better observation of the papillae in ectopic locations. The diagnosis of ectopic papillae can be done by radiological studies also but they are expensive and not affordable by all patients so most of the cases of ectopic papillae are identified by ERCP. An ectopic location, distal to the second part, in the third or fourth parts of duodenum has been described frequently but a proximal location is rare. Only a few cases have been found to be located in the gastric, pyloric and duodenal bulb areas. We report three such rare cases of anomalous ectopic ampullae discovered during the performance of ERCP from the Department of Gastroenterology, Combined Military Hospital, Dhaka and also a short review of the literature. In these three subjects one papilla was located in the pylorus and other two in the first part of the duodenum. All of them presented with features of choledocholithiasis with cholangitis. They were successfully managed by therapeutic ERCP. Clinical implications of these rare anomalies and anatomical variations can assist the gastroenterologists in effective patient management.

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“…Ectopic opening of the CBD into any site other than the second portion of the duodenum is quite rare. However, it can terminate at anomalous sites, including the third or fourth portion of the duodenum, the pyloric canal or duodenal bulb (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Although ectopic accessory bile ducts entering the stomach have been reported rarely, there have been only three cases of CBD opening directly into the stomach (1-6).…”

Section: Discussionmentioning

confidence: 99%

“…First, a hook-shaped configuration of the distal CBD, which may result from an acute angulation of the CBD caused by premature drainage of bile into the stomach, may be associated with bile stasis. This hook-shaped configuration of the distal CBD should be considered the characteristic finding for this anomaly (16). Second, a typical configuration of the major duodenal papilla was absent, but a slit-like orifice was present.…”

Section: Discussionmentioning

confidence: 99%