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Progressive biliary pathology associated with common pancreato-biliary channel
P Pushparani1, R G Redkar, E R Howard
1Department of Paediatric Surgery, King's College Hospital, London, England.
Journal of Pediatric Surgery
|April 19, 2000
Summary
This study tracked a patient with a rare common pancreato-biliary channel, observing progressive gallbladder polyps and bile duct changes over 17 years. Findings highlight the impact of pancreato-biliary reflux on extrahepatic duct pathology.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Hepatology
Background:
- A female infant presented with transient obstructive jaundice.
- Mild fusiform dilatation of the common bile duct was noted at 18 months.
Observation:
- Long-term follow-up (17 years) using hepatobiliary ultrasound revealed enlarging gallbladder polyps.
- Endoscopic retrograde cholangio-pancreatography (ERCP) identified a common pancreato-biliary channel with minimal bile duct dilatation and high pancreatic amylase in bile.
Findings:
- Histological examination showed fibrous thickening and epithelial loss in the common bile duct.
- Gallbladder exhibited muscular hypertrophy, polypoid lesions (cholesterosis), and minimal lymphocytic infiltrate.
Implications:
- This case demonstrates progressive ultrasound and histological changes in extrahepatic ducts.
- These changes are secondary to a common pancreato-biliary channel and subsequent pancreato-biliary reflux.