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Aberrant pancreatic ductal organisation: a case report

  • Anatomic Variations
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Abstract

Anomalous pancreatic ductal system has always enthralled the anatomists, surgeons, gastroenterologists and radiologists alike. With the growing use of MRCP, ERCP and endoscopic and surgical procedures, the knowledge of anatomical aberrations of pancreaticobiliary tract becomes extremely important. Moreover, the anomalous pancreatic duct morphology may be responsible for atypical gastrointestinal complains. We report an exceptionally rare case of two accessory ventral pancreatic ducts opening separately into the common bile duct proximal to the hepato pancreatic ampulla. Concomitant occurrence of an ectopic major duodenal papilla, 3.8 cm distal to the pyloric end of stomach was also seen. Moreover, the accessory pancreatic duct and the minor duodenal papilla were absent. Clinical implications and embryological description of these rare anomalies are discussed. Awareness of such rare morphological variants can go a long way in assisting effective patient management.

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References

  1. Guerra I, Rábago LR, Bermejo F, Quintanilla E, García-Garzón S (2009) Ectopic papilla of Vater in the pylorus. World J Gastroenterol 15:5221–5223

    Article  PubMed Central  PubMed  Google Scholar 

  2. Kamisawa T, Takuma K, Anjiki H, Egawa N, Kurata M, Honda G, Tsuruta K, Sasaki T (2009) Pancreaticobiliary maljunction. Clin Gastroenterol Hepatol 7:S84–S88

    Article  PubMed  Google Scholar 

  3. Kamisawa T, Takuma K, Tabata T, Egawa N (2010) Clinical implications of accessory pancreatic duct. World J Gastroenterol 16:4499–4503

    Article  PubMed Central  PubMed  Google Scholar 

  4. Kubota T, Fujioka T, Honda S, Suetsuna J, Matsunaga K, Terao H, Nasu M (1988) The papilla of Vater emptying into the duodenal bulb. Report of two cases. Jpn J Med 27:79–82

    Article  CAS  PubMed  Google Scholar 

  5. Lee HJ, Ha HK, Kim MH, Jeong YK, Kim PN, Lee MG, Kim JS, Suh DJ, Lee SG, Min YI, Auh YH (1997) ERCP and CT findings of ectopic drainage of the common bile duct into the duodenal bulb. Am J Roentgenol 169:517–520

    Article  CAS  Google Scholar 

  6. Lee SS, Kim MH, Lee SK, Kim KP, Kim HJ, Seo DW, Ha HK, Kim JS, Kim CD, Chung JP, Min YI (2003) Ectopic opening of the common bile duct in the duodenal bulb: clinical implications. Gastrointest Endosc 57:679–682

    Article  PubMed  Google Scholar 

  7. Moore KL (1986) Embriologia Clínica, 3rd edn. Guanabara Koogan, Rio de Janeiro, pp 216–223

    Google Scholar 

  8. Pereira-Lima J, Pereira-lima L, Nestrowski M, Cuervo C (1974) Anomalous location of the papilla of Vater. Am J Surg 128:71–74

    Article  CAS  PubMed  Google Scholar 

  9. Poppel MH (1951) Roentgen manifestations of pancreatic disease. Blackwell Scientific Publications, Oxford

    Google Scholar 

  10. Shimada K, Yanagisawa J, Nakayama F (1991) Increased lysophosphatidylcholine and pancreatic enzyme content in bile of patients with anomalous pancreaticobiliary ductal junction. Hepatology 13:438–444

    Article  CAS  PubMed  Google Scholar 

  11. Standring S (2008) Gray’s anatomy—the anatomical basis of clinical practice, 40th edn. Elsevier, Spain, pp 1125–1126, 1206

Download references

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The authors declare that they have no conflicts of interest to disclose.

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The study complies with the current laws of the country in which it was performed (India).

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Correspondence to Shivi Goel.

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Goel, S., Rustagi, S.M., Saha, S. et al. Aberrant pancreatic ductal organisation: a case report. Surg Radiol Anat 37, 543–546 (2015). https://doi.org/10.1007/s00276-015-1474-z

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  • DOI: https://doi.org/10.1007/s00276-015-1474-z

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