Anomalous pancreaticobiliary union and chronic pancreatitis: rare presentation with biliary peritonitis

Abstract

Anomalous pancreaticobiliary union (APBU) has varied presentations. We report the case of a 12-year-old female who presented with biliary peritonitis due to a perforation of the common bile duct due to impaction of a pancreatic calculus at the duodenal papilla. She had a long common-biliary channel and pancreas divisum with chronic calcific pancreatitis involving the pancreatic head and neck. To our knowledge, this is the first such reported case in the literature.

Spontaneous common hepatic duct perforation in a child: A rare case report

“…In PBM, repeated reflux of pancreatic juice into CBD causes chronic inflammation and microabscess formation in the wall of CBD, which may results in SBDP. [910]Our case is special with respect to site of perforation that is CHD, that has been reported only in very few cases in adults, however, to the best of our knowledge, no case has been reported in children. Whatever be the cause of perforation or site of perforation, the modality of basic treatment remains same in all the cases.…”

Spontaneous common bile duct perforation- a rare cause of biliary peritonitis in a patient of chronic calcific pancreatitis.

“…pancreatic stula and malignancy [2] . Chronic pancreatitis presenting as biliary peritonitis secondary to CBD perforation to our knowledge has only been reported three times and all three were in paediatric age group and had impacted pancreatic calculus at duodenal papilla [3] and one patient had APBJ [5] .…”

Spontaneous Rupture of Extrahepatic Choledochal Cyst: Two Pediatric Cases and Literature Review

“…Some other authors agree that anomalous insertion of the pancreatic duct into the common channel, which has been recently named common channel syndrome, appears to facilitate reflux of pancreatic secretions into the biliary tree, causing weakness at a certain site in the cyst wall. These researchers believe that this may contribute to the formation, and even rupture, of a choledochal cyst [17,20,22]. In their latest report, Ando et al supported part of this theory, concurring that perforation may result from irritation of the cyst wall due to refluxed pancreatic juice.…”