Ulcerated choledochocele: A case report

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Surgical Innovation

Background:

• Choledochocele, a rare cystic dilatation of the distal common bile duct, infrequently causes massive gastrointestinal bleeding.
• This case highlights an unusual presentation of a rare biliary tract anomaly.

Purpose of the Study:

• To report a rare case of choledochocele presenting with massive lower gastrointestinal bleeding.
• To emphasize the utility of minimal access surgical techniques in managing this condition.

Main Methods:

• A 13-year-old boy presented with hematochezia and syncope.
• Initial upper endoscopy revealed a submucosal mass near the ampulla of Vater.
• Emergency laparotomy and duodenotomy identified and treated the choledochocele via de-roofing and marsupialization.

Main Results:

• The choledochocele was successfully treated with a de-roofing and marsupialization procedure.
• The patient experienced a postoperative complication of adhesive small bowel obstruction, managed laparoscopically.
• The patient was discharged in good condition.

Conclusions:

• Choledochocele should be considered in the differential diagnosis of submucosal masses in the duodenum, especially when presenting with gastrointestinal bleeding.
• Upper gastrointestinal endoscopy is crucial for evaluating massive lower GI bleeding potentially originating from duodenal pathology.