Gallstone-containing duodenal duplication communicating with the pancreatic duct

A 10-year-old female patient with duodenal duplication containing gallstones and communicating with the pancreatic and bile ducts is described. Although endoscopic retrograde cholangiopancreatography and computed tomography following intravenous cholangiography showed a periampullary cystic lesion, the precise relationship between the lesion and the pancreaticobiliary ductal system was not clear. After removal of the gallstones by opening the cystic lesion, a pinhole opening noticed inside was cannulated and contrast injected, demonstrating a connection between the cystic lesion and the pancreatic and bile ducts. Both the outside and inside of the lesion were lined by duodenal mucosa. Partial excision and cystoduodenostomy were performed. The imaging techniques described herein are useful for establishing the correct diagnosis and planning a surgical approach for this condition.