Ann Hepatobiliary Pancreat Surg.  2017 Feb;21(1):52-56. 10.14701/ahbps.2017.21.1.52.

A rare case of choledochal cyst with pancreas divisum: case presentation and literature review

• Ransom-Rodríguez A
• Blachman-Braun R
• Sánchez-García Ramos E
• Varela-Prieto J
• Rosas-Lezama E
• Mercado MA

• KMID: 2371568
• DOI: http://doi.org/10.14701/ahbps.2017.21.1.52

Abstract

Choledochal cysts are rare congenital malformations of the bile duct characterized by dilatations of the intrahepatic and/or extrahepatic portion of the biliary tree, they are associated to an anomalous arrangement of the pancreaticobiliary duct. Pancreas divisum results from a fusion failure of the pancreatic buds. The coexistence of pancreas divisum and choledochal cyst in adults has been reported in less than 10 well documented cases. This article presents a case of a 42-year-old Peruvian man with intermittent episodes of abdominal pain, initially diagnosed with choledocholithiasis, who underwent open cholecystectomy. During surgery, a diagnosis of choledochal cyst and pancreas divisum was made, and therefore a hepaticoduodenostomy was performed. The patient was referred to our hospital due to persistence of abdominal pain. After admission, a papillectomy was achieved without further complications. A cyst resection and dismantling of hepaticoduodenostomy with Roux-en-Y was performed 8 years later. During the subsequent 18-month follow-up, the patient remains asymptomatic.

Keyword

Bile duct cysts; Choledochal cyst; Pancreas divisum; Pancreatitis

MeSH Terms

Abdominal Pain
Adult
Bile Ducts
Biliary Tract
Cholecystectomy
Choledochal Cyst*
Choledocholithiasis
Diagnosis
Dilatation
Follow-Up Studies
Humans
Pancreas*
Pancreatitis

Figure

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  Fig. 1 Endoscopic retrograde cholangiopancreatogram. Injection of iodine contrast agent into the major duodenal papilla reveals its amputation. Opacification of the principal and secondary pancreatic duct with an independent drainage is identified. A saccular image was also observed on the common bile duct.

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