2008 Volume 44 Issue 5 Pages 700-703
A one-year-old girl presented with acute vomiting and abdominal pain. Computed tomography (CT) performed at a local hospital showed swelling of the pancreas which suggested acute pancreatitis. The biliary duct was not dilated. Enhanced coronal reconstructive CT performed at our hospital revealed that the pancreatic duct joined to the common bile duct forming a common channel. She was diagnosed with pancreatobiliary maljunction (PBMJ) without bile duct dilatation. She underwent excision of the gallbladder and the extrahepatic bile duct followed by a Roux-en-Y hepaticojejunostomy. For the diagnosis of PBMJ, endoscopic retrograde cholangiopancreatography (ERCP) is commonly used. However, ERCP requires general anesthesia in infants and radiation exposure, and has a risk of pancreatitis after the procedure. Recently, magnetic resonance cholangiopancreatography (MRCP) has been applied for the diagnosis of choledochal cysts. The disadvantage of MRCP for children is that they require deep sedation for a relatively long period and the imaging resolution is not always adequate for detecting PBMJ. Enhanced coronal reconstructive CT is performed easily even in infants, and its resolution is much superior to that of MRCP. Multi-detector CT can reduce radiation exposure and scanning time to eliminate motion artifact. We report the possibility of CT imaging for the diagnosis of PBMJ in infants.
