Ectopic opening of the common bile duct into various sites of the upper digestive tract: a case series

Retrospective analysis of cases with an ectopic opening of the common bile duct into duodenal bulb

“…However, it has been reported in the 3 rd or 4 th portion of the duodenum, pyloric canal, duodenal bulb, and the stomach. [2][3][4][5] The clinical and endoscopic features, and the significance of EOCBD are not sufficiently known. It is associated with benign biliary diseases, but usually manifests with recurrent duodenal ulcer, bulbus deformity with accompanying dilatation of the extra-and intrahepatic bile ducts with pneumobilia and stone.…”

Ectopic Opening of the Common Bile Duct Accompanied by Choledochocele and Pancreas Divisum

“…Some previous reports described the presence of the major papilla in the second portion of the duodenum (1, 6, 7). In other reports, the pancreatic duct was visualized in fewer than half of the total cases (2)(3)(4)(5)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), which suggests the possibility of another orifice joining with the pancreatic duct. Moreover, from the viewpoint of the embryonic process, the presence of the major papilla is consistent with Boyden's theory (30), as described above.…”

“…Previous reports have suggested that the incidence of PD in autopsy cases is about 9% (21,22). To our knowledge, this is the first report of an ectopic opening of the CBD into the duodenal bulb accompanied by choledochocele and PD (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Choledochocele concomitant with PD is also rare, with only three case reports having been published (25)(26)(27); therefore, our case is extremely rare.…”

“…The diagnostic criteria of ectopic openings of the CBD have not yet been established. In previous reports, such a diagnosis was often described as being made based on the following findings: 1) an orifice was observed in the stomach, bulb, or third portion of the duodenum by duodenoscopy or upper endoscopy, and the bile duct and/or the pancreatic duct were directly visualized radiographically when contrast medium was injected via this opening; 2) there was no evidence of any other drainage into the digestive tract on cholangiography; and 3) there was no evidence of a papilla-like structure in the second portion of the duodenum on duodenoscopic examination (3,4,8,12,15). In our case, the major papilla was observed at the normal location in the second portion of the duodenum, and the ventral pancreatic duct was joined to the major papilla.…”

“…Ectopic opening of the common bile duct (CBD) is a rare congenital biliary anomaly, with the CBD emptying into anomalous sites such as the third or fourth portion of the duodenum, stomach, or duodenal bulb (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Choledochocele is also a biliary anomaly, with cystic dilatation of the intraduodenal segment of the CBD (18)(19)(20).…”