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Unclassifiable Congenital Biliary Dilatation With a Meandering Main Pancreatic Duct and Suspected Pancreaticobiliary

Yugang Shim1, Akinori Sekioka2, Shuichi Ota2

  • 1Department of Gastrointestinal Surgery, Osaka Saiseikai Noe Hospital, Osaka, JPN.

Cureus
|April 7, 2025
PubMed

Insights

This case report details a rare coexistence of congenital biliary dilatation (CBD), meandering main pancreatic duct (MMPD), and suspected pancreaticobiliary maljunction (PBM). Surgical intervention relieved the patient's abdominal pain.

Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Pathology
  • Congenital Anomalies

Background:

  • Congenital biliary dilatation (CBD) is defined by bile duct dilation, often linked to pancreaticobiliary maljunction (PBM).
  • Pancreaticobiliary maljunction (PBM) involves anomalous anatomical merging of pancreatic and bile ducts outside the duodenal wall.
  • Meandering main pancreatic duct (MMPD) is a ductal anomaly characterized by a Z-shape or loop in the pancreatic head.

Observation:

  • A 30-year-old male presented with intermittent right upper abdominal pain.
  • The patient exhibited an unclassifiable type of CBD, MMPD, suspected PBM, and chronic cholecystitis.
  • These conditions represent an uncommon clinical presentation.

Findings:

  • The study presents the first reported case of concurrent unclassifiable CBD, MMPD, and suspected PBM.
  • Pathophysiological analysis was conducted to understand the cause of the patient's symptoms.
  • Laparoscopic cholecystectomy resulted in symptom resolution.

Implications:

  • This case highlights the importance of recognizing rare combinations of congenital biliary and pancreatic ductal anomalies.
  • Understanding the pathophysiology of these combined anomalies is crucial for diagnosis and management.
  • Surgical management, such as cholecystectomy, may effectively alleviate symptoms in such complex cases.

Keywords:
chronic cholecystitiscongenital biliary dilatationlaparoscopic cholecystectomy (lc)meandering main pancreatic ductpancreaticobiliary maljunction

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