Abstract
A 78-year-old woman was admitted to our hospital because of right upper quadrant pain. Ultrasonography showed the dilated biliary tree and debris-like echoes in the gallbladder. Percutaneous transhepatic biliary drainage was performed, and the cholangiogram demonstrated a filling defect in the choledochus due to mucinous material. Per-cutaneous aspiration of the gallbladder also yielded mucinous material and the subsequent contrast injection disclosed a f istulous communication with the duodenum. Endoscopy revealed a submucosal mass covered with mucus at the superior duodenal angulus and widened orifice of the major papilla. Mucin-producing carcinomas of the gallbladder are rare and, to the best of our knowledge, this is the first case accompanied by internal billiary fistula and widened orifice of the major papilla.
