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Biliary diverticulum with pancreaticobiliary maljunction

Y Ikematsu1, T Eto, T Tomioka

  • 1Second Department of Surgery, Nagasaki University School of Medicine, Japan.

Hepato-Gastroenterology
|February 1, 1994
PubMed
Summary
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This study reports a rare case of a 48-year-old man with a small biliary diverticulum and pancreaticobiliary maljunction. Surgical removal of the gallbladder led to a positive outcome, highlighting a unique clinical presentation.

Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Case Reports

Background:

  • Pancreaticobiliary maljunction (PBM) is a congenital anomaly where the pancreatic and bile ducts join outside the duodenal wall.
  • Biliary diverticula, particularly Type B (intrahepatic bile duct dilatation), are uncommon findings.
  • The co-occurrence of PBM and Type B biliary diverticulum is exceedingly rare.

Observation:

  • A 48-year-old Japanese male presented with epigastric distress, initially suspected gallstones and gallbladder adenomyomatosis.
  • Endoscopic retrograde cholangiopancreaticography revealed a 3 mm intrahepatic biliary diverticulum and PBM.
  • Intra-operative cholangiography confirmed these findings.

Findings:

  • The patient underwent cholecystectomy alone.
  • Histological examination confirmed gallbladder adenomyomatosis with intramural calculi.

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  • The patient recovered well with mild, persistent hyperamylasemia over 18 months post-surgery.

    • Implications:

    • This case represents one of only three reported instances of Type B bile duct dilatation associated with PBM in the literature.
    • The smaller size of the diverticulum in this case compared to previous reports is noted.
    • Further investigation into the relationship between PBM and Type B biliary diverticulum is warranted.