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- W1971567162 abstract "Introduction: The major papilla of Vater is usually located in the descending part of the duodenum on the posterior medial wall. Occasionally it may be found in other sites, including the stomach, the pyloric canal, the duodenal bulb and the third or the fourth portion of the duodenum. Most commonly, the distance between the pyloric sphincter and the papilla of Vater is longer than 5cm. Case: A 68 old male was admitted to our hospital because of painful obstructive jaundice. The patient had relapsing ulcer disease for more than 40 years and some episodes of spontaneously disappearing obstructive jaundice, but unsuccessful ERCP at one occasion. Abdominal US, CT and MRCP revealed extremly dilated (up to 30mm) common bile duct, stones in the gallbladder and the common bile duct, and a large abscess in the antral wall of the stomach. ERCP was performed. No papilla-like structure was found in the usual position, but the separate opening of the common bile duct and pancreatic duct were found in the pyloric canal. The common bile duct stones were removed after balloon dilation of the biliary opening and a 7-French double pigtail stent was inserted into the biliary tree by duodenoscope positioned in the antral region of the stomach. After desicterisation of the patient elective surgery was performed containing the followings procedures: cholecystectomy, biliodigestive anastomosis and evacuation of the subphrenic abscess. The patient recovered uneventfully. Discussion: Anomalous biliary opening outside the usual localisation can make ERCP difficult. Moreover, the procedure cannot be performed, if the anomy in not notified at all. In our case, the anomalous outflow of the bile and pancreatic juice could be associated with recurrent, intractable duodenal ulcer and recurrent biliary obstruction." @default.
- W1971567162 created "2016-06-24" @default.
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- W1971567162 date "2010-05-01" @default.
- W1971567162 modified "2023-09-25" @default.
- W1971567162 title "Insertion of a biliary stent from the stomach. case report of ectopic opening of the common bile duct in the pyloric canal" @default.
- W1971567162 doi "https://doi.org/10.1055/s-0030-1254761" @default.
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