1/266. Choledochoduodenal fistula at the anterior wall of the duodenal bulb: a rare complication of duodenal ulcer.A 38 year-old man was admitted to our hospital with the chief complaint of epigastralgia. His laboratory data revealed leukocytosis and increased serum amylase, and abdominal ultrasonography revealed diffuse swelling of the pancreas. Thus, he was diagnosed as having acute pancreatitis. Moreover, abdominal computed tomography showed pneumobilia in the gallbladder and the common bile duct. Gastroduodenal fiberscopy demonstrated peptic ulcer scars around a foramen with smooth margins at the anterior wall of the duodenal bulb. The bile juice flowed from the bottom of the foramen. Endoscopic retrograde cholangiopancreatography revealed the fistula between the common bile duct and the anterior wall of the duodenal bulb, but not the posterior wall. However, there was no pancreatico-biliary maljunction and no stones in the gallbladder or bile duct. This is a rare case of choledochoduodenal fistula at the anterior wall of the duodenal bulb caused by duodenal peptic ulcer disease.- - - - - - - - - - ranking = 1keywords = duct, stone (Clic here for more details about this article) |
2/266. Obstructive jaundice and acute cholangitis due to papillary stenosis.Papillary stenosis is characterized by fixed fibrosis leading to structural outflow obstruction and it is usually secondary to inflammation and fibrosis from the chronic passage of gallstones, episodes of acute pancreatitis, chronic pancreatitis, sclerosing cholangitis, peptic ulcer disease, and cholesterolosis. However, obstructive jaundice with or without acute cholangitis which leads the physician to suspect the presence of malignancy as a cause is a rare manifestation of papillary stenosis. We report here a case of papillary stenosis presenting with obstructive jaundice and acute cholangitis. The lesion was so difficult to exclude the presence of malignancy preoperatively and intraoperatively that a pylorus-preserving pancreaticoduodenectomy was performed. Histologic examination of the resected specimen revealed fibrosis, adenomatoid ductal hyperplasia, and mild chronic inflammation of the papilla of Vater and distal common bile duct.- - - - - - - - - - ranking = 0.66850849400963keywords = duct, stone, ductal (Clic here for more details about this article) |
3/266. Long term treatment of biliary stricture due to chronic pancreatitis with a metallic stent.The exact role of endoprostheses in the management of chronic pancreatitis-associated biliary strictures has not yet been clearly established. We report an unusual case of a patient with this condition who was treated for an unexpectedly long term with a self-expanding metallic endoprosthesis. There has only been one previous report of the use of metallic stents in this situation. It appears that metallic endoprostheses may have a role to play in the management of selected patients who have chronic pancreatitis-associated bile duct stricture.- - - - - - - - - - ranking = 0.33238543299673keywords = duct (Clic here for more details about this article) |
4/266. Isolated common bile duct tuberculosis.We report a patient with isolated involvement of common bile duct by tuberculosis. The diagnosis was established by histological examination of the resected specimen. Surgery and antitubercular chemotherapy resulted in complete recovery.- - - - - - - - - - ranking = 1.6619271649837keywords = duct (Clic here for more details about this article) |
5/266. gallbladder carcinoma with choledochoduodenal fistula: a case report with surgical treatment.A 79 year-old man was admitted to our hospital because of upper abdominal pain and nausea. A mobile tumor was palpable in the right upper abdomen. Abdominal ultrasonography, computed tomography and celiac angiography revealed a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed a fistula 1.5 cm oral to the orifice of the papilla of Vater, dilatation of the common bile duct, and a filling defect in the gallbladder. Pancreatoduodenectomy associated with reconstruction using Imanaga's method was performed under a pre-operative diagnosis of gallbladder carcinoma with choledochoduodenal fistula. The gallbladder contained a tumor and two bilirubin stones impacted in the orifice of the duodenal papilla. Histological studies confirmed that the gallbladder tumor was a mucinous adenocarcinoma and had not infiltrated the bile duct. We speculated that choledochoduodenal fistula stimulated the development of cancer due to chronic irritation from pancreatic juice reflux.- - - - - - - - - - ranking = 0.66761456700327keywords = duct, stone (Clic here for more details about this article) |
6/266. Abdominal distention and shock in an infant.Acute abdominal distention in the pediatric patient may be attributable to extraperitoneal fluid, masses, organomegaly, air, an ileus, a functional or mechanical bowel obstruction, or injury and blood secondary to trauma. An infant who presents to the emergency department with acute abdominal distention and shock is a true emergency for which the differential diagnosis is extensive. An unusual case of abdominal distention, ascites, hematochezia, and shock in an infant, subsequently found to have spontaneous perforation of the common bile duct is reported. This uncommon cause of abdominal distention and shock in an infant is many times left out of the differential diagnosis of an acute abdomen. The presentation may be as an uncommon acute form or a classis subacute type. This patient had hematochezia, which had not been previously reported in association with this entity. Failure to recognize and treat an acute abdomen can result in high mortality.- - - - - - - - - - ranking = 0.33238543299673keywords = duct (Clic here for more details about this article) |
7/266. Biliary ascariasis: CT, MR cholangiopancreatography, and navigator endoscopic appearance--report of a case of acute biliary obstruction.A case of acute common bile duct obstruction caused by a roundworm in a 6-year-old girl is reported. Computed tomography (CT) and magnetic resonance imaging (MRI) showed "bull's-eye" and "eye-glass" appearances of the ascaris in the common bile duct. On reformation of the transverse CT and coronal MR images, the tubular ascaris was better depicted. MRI and navigator endoscopic demonstrations of the common bile duct ascaris have not been described previously in the literature. These CT and MRI findings may be helpful in the diagnosis of ascaris.- - - - - - - - - - ranking = 0.9971562989902keywords = duct (Clic here for more details about this article) |
8/266. Spontaneous perforation of the common bile duct in infancy: role of Tc-99m mebrofenin hepatobiliary imaging.A 2-month-old infant had jaundice that began 3 days after birth. The clinical features were suggestive of biliary obstruction. Tc-99m mebrofenin hepatobiliary imaging confirmed the diagnosis of spontaneous perforation of the common bile duct, and surgical intervention resulted in progressive recovery.- - - - - - - - - - ranking = 1.6619271649837keywords = duct (Clic here for more details about this article) |
9/266. cholecystostomy: an unusual approach to stenting of a distal common bile duct stricture.Strictures, both benign and malignant, of the distal common bile duct (CBD) are reasonably common, and if stented are usually approached endoscopically via the duodenum, or transhepatically via an intrahepatic and then common hepatic duct. We describe a case of endoscopic stenting of a distal CBD stricture over a wire passed percutaneously through the gallbladder, cystic duct and into the duodenum. To our knowledge, this has not been previously described.- - - - - - - - - - ranking = 2.3266980309771keywords = duct (Clic here for more details about this article) |
10/266. Repair of common bile duct injury with the round and falciform ligament after clip necrosis: case report.Occasionally, as abdominal surgeons, we are confronted with common bile duct injury noted during video laparoscopic or open cholecystectomy. Usually this is solved by endoscopic retrograde cholangiopancreatography (ERCP) sphincterotomy and stent, or enteric bypass, suture repair and tube drainage. However, after such procedures, there is a significant number of patients with postoperative stenosis. Another alternative to repair common bile duct injury and correct postoperative stenosis is using the round and falciform ligament as circumferencial patch. Due to their closeness to the common bile duct and their adequate blood supply, they make a perfect autologous biological graft.- - - - - - - - - - ranking = 2.3266980309771keywords = duct (Clic here for more details about this article) |
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