Dilated Pancreatic Duct and Common Bile Duct in a Patient with Abdominal Pain and Weight Loss

2004 ◽  
Vol 99 (8) ◽  
pp. 1623-1625 ◽  
Author(s):  
Banke Agarwal ◽  
Stephen Kuehn ◽  
Brian T. Collins
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Pancreatic Duct

scholarly journals Brunner’s gland hamartoma: a cause of the double-duct sign

2016 ◽  
Vol 98 (6) ◽  
pp. e92-e93 ◽  
Author(s):  
M Kostalas ◽  
P Jackson ◽  
N Karanjia
Keyword(s):  
Weight Loss ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Pancreatic Duct ◽  
Biliary Obstruction ◽  
Rare Case ◽  
Periampullary Cancer ◽  
Brunner’S Gland ◽  
The Common ◽  
Brunner's Gland

Introduction Brunner’s glands are submucosal glands found in the duodenum. Proliferation of these glands can lead to the formation of Brunner’s gland hamartomas (BGHs), which are uncommon, asymptomatic and usually found incidentally. They are predominantly benign lesions, but instances of malignant transformation have been reported. Case History We describe a rare case in which a periampullary lesion was causing biliary obstruction on a background of weight loss, and was associated with dilatation of the common bile duct and pancreatic duct on computed tomography and magnetic resonance imaging. Further investigation with endoscopic ultrasound and biopsy did not provide a definitive diagnosis. Given the symptoms and findings upon investigations, we proceeded to pylorus-preserving pancreatoduodenectomy. Conclusions This was a rare case in which BGH gave rise to biliary obstruction against a background of weight loss. Due to a high index of suspicion (weight loss and evidence of dilatation of the common bile duct and pancreatic duct), this procedure was justified because the consequences of a missed periampullary cancer far outweighed surgical risks.

scholarly journals Cholangiocarcinoma Arising from a Type VI Biliary Cyst: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
İlkay Çamlıdağ ◽  
Mehmet Selim Nural ◽  
Murat Danacı ◽  
İlhan Karabıçak ◽  
Kağan Karabulut
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
Unusual Case ◽  
The Other ◽  
Review Of The Literature ◽  
Imaging Studies ◽  
Biliary Cyst

Cystic dilatations of the cystic duct which are suggested as type VI biliary cysts are very rare and many of them go unrecognized or are confused with other cysts until the operation although they are obvious on imaging studies. They can present with fusiform or saccular dilatations and can be accompanied by common bile duct dilatations. It is important to identify these cysts as they share the same characteristics as the other biliary cyst types and can be complicated with malignancy. We herein present a very unusual case of a cholangiocarcinoma arising from a type VI biliary cyst in a 58-year-old female patient and review the literature. The patient presented with jaundice, weight loss, and abdominal pain. On imaging, the cystic duct and common bile duct were fusiformly dilated and had a wide communication. There was a mass filling the distal parts of both ducts. The patient was urgently operated on after perforation following ERCP. Histopathology was compatible with a type VI biliary cyst and an associated cholangiocarcinoma.

scholarly journals Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

2019 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Giulia Frauenfelder ◽  
Annamaria Maraziti ◽  
Vincenzo Ciccone ◽  
Giuliano Maraziti ◽  
Oliviero Caleo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdominal Pain ◽  
Imaging Modality ◽  
Biliary Duct ◽  
History Of ◽  
The Common ◽  
Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

Gallstones and Biliary Tract Emergencies

2020 ◽  
Author(s):  
Luis F. Lobon ◽  
Michael Billington
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Cholecystitis ◽  
Biliary Tract ◽  
Bile Ducts ◽  
Gallbladder Disease ◽  
Diagnosis And Treatment ◽  
Hepatic Bile ◽  
Ascending Cholangitis

Patients with diseases of the biliary tract (which includes the hepatic bili canaliculi, hepatic bile ducts, common bile duct, and gallbladder) typically present with symptoms that include abdominal pain, nausea, vomiting, and jaundice. This review covers the pathophysiology, assessment and stabilization, diagnosis and treatment, and disposition and outcomes for common biliary tract emergencies (cholelithiasis, acute cholecystitis, choledocholithiasis, and ascending cholangitis).  This review contains 5 figures, 11 tables, and 34 references. Keywords: Cholelithiasis, gallbladder disease, acute cholecystitis, gallstones, choledocholithiasis, ascending cholangitis

Case 4.25

2014 ◽  
pp. 234-235
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Liver Function ◽  
Pancreatic Duct ◽  
Liver Function Tests ◽  
Filling Defect ◽  
Distal Common Bile Duct ◽  
Biliary Dilatation ◽  
Function Tests ◽  
Elevated Liver Function Tests

64-year-old man with elevated liver function tests MIP image from 3D FRFSE MRCP (Figure 4.25.1) reveals a filling defect in the distal common bile duct, diffuse intrahepatic biliary dilatation, and mild dilatation of the pancreatic duct. Coronal oblique SSFSE images (Figure ...

Endoscopic retrograde cholangio-pancreatography: a review for endoscopy nurses and assistants

2019 ◽  
Vol 17 (Sup8) ◽  
pp. S8-S14
Author(s):  
Muhammad Waqas Fazal ◽  
Maria Tan ◽  
Shyam Menon
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Pancreatic Duct ◽  
Clinical Outcomes ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Patient Selection ◽  
Basic Knowledge ◽  
Endoscopic Retrograde ◽  
The Common

Endoscopic retrograde cholangiopancreatography (ERCP) facilitates endoscopic access to the common bile duct and pancreatic duct. It has become central to the management of a variety of benign and malignant pancreatobiliary disorders. ERCP remains a technically challenging procedure and patient selection and pre-assessment is critical to ensure good clinical outcomes. Staff assisting in ERCP should familiarise themselves with the underlying principles and basic knowledge pertaining to various aspects of ERCP.

scholarly journals Gallstone Pancreatitis: A Common but Often Overlooked Cause of Abdominal Pain in Post-Liver-Transplant Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Napatt Kanjanahattakij ◽  
Kamolyut Lapumnuaypol ◽  
Sanna Fatima ◽  
Eyob Feyssa
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Liver Transplant ◽  
Gall Stone ◽  
Elevated Serum ◽  
High Dose ◽  
Gallstone Pancreatitis ◽  
Serum Lipase ◽  
Transplant Patients

Introduction. In general population, gallstone pancreatitis is the most common cause of pancreatitis. However, there are very few literatures that address this topic in post-liver-transplant patients. Clinical Case. A 69-year-old female who had a liver transplant in 2015 due to hepatocellular carcinoma and nonalcoholic steatohepatitis (NASH) cirrhosis. She had a recent episode of acute cellular rejection that was treated with high dose methylprednisolone 1 week prior to admission. She presented with severe epigastric abdominal pain associated with nausea and vomiting. Her laboratory studies showed significantly elevated serum lipase, AST, and ALT from her baseline. She underwent urgent Endoscopic Ultrasound (EUS) with Endoscopic Retrograde Cholangiopancreatography (ERCP) that showed common bile duct stone that was extracted. Discussion. Biliary sludge and stones accounted for 22% of late onset acute pancreatitis after liver transplant. Corticosteroids have been identified as one of the potential causes of drug-induced pancreatitis. However, she is more likely to have gall stone pancreatitis since she also had dilated common bile duct and intrahepatic duct. In addition, there was CBD stone noted on ERCP. Conclusion. Acute gallstone associated pancreatitis after liver transplant is not uncommon. Patients generally have good outcomes. Further prospective studies are warranted.

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