Intraduodenal Diverticulum Associated with a Double Common Bile Duct Causing Recurrent Pancreatitis and Cholangitis: Report of a Case

Abstract

Intraduodenal diverticulum (IDD) is a rare congenital anomaly, arising at or near the papilla of Vater. Double common bile duct (DCBD) is another rare congenital anomaly of the biliary system. Recognition of these abnormalities is essential to prevent the development of lesions in the biliary system, as well as to avoid unnecessary surgical intervention. Although both conditions are often asymptomatic, severe clinical conditions may develop. Intraduodenal diverticulum should always be considered as a possible cause of pancreatitis of unknown etiology. We report a rare case of IDD with DCBD in a patient with Lemmel's syndrome, which consists of obstructive jaundice, acute pancreatitis, and suppurative cholangitis. The patient was treated successfully with a Roux-en-Y hepaticojejunostomy.

Treatment Options of Lemmel’s Syndrome: A Case of Benign Obstructive Jaundice in The Elderly

“…However, PAD are sometimes filled with fluid and frequently be misinterpreted with pancreatic pseudocyst, pancreatic abscess, cystic neoplasm in the pancreas head or even metastatic lymph node. 1,[23][24][25] Therefore, high index of suspicion is necessary to establish right diagnosis in such cases. In our case, the common bile duct dilatation of PAD.…”

Mechanical and Anatomical Causes of Bile Duct

“…Sometimes, food impaction in a duodenal diverticulum induces biliary obstruction (Van der Linde et al 1997). Intraduodenal diverticulum has been reported to be associated with double common bile duct causing cholangitis (Martins et al 2007).…”