Abstract
A 71-year-old female was admitted to our hospital because of advanced cholangiocellular carcinoma. She underwent endoscopic retrograde cholangiopancreatography for evaluation of the tumor. Endoscopically, the longitudinal fold of the major duodenal papilla was slightly swelling but readily compressible with a smooth appearance before cannulating. Cholangiography in the initial phase showed no abnormal findings in the terminal common bile duct. The mucosa proximal to the orifice bulged endoscopically into the duodenum, during contrast injection from the cannulating catheter situated in the terminal common bile duct near the orifice. Cholangiography demonstrated a round contrast-filled structure adjacent to the termination of the common bile duct.
In conclusion, choledochocele could be diagnosed by duodenoscopic and cholangiographic findings during ERCP. Ballooning of the papilla during contrast injection is a clue to the presence of a choledochocele. It might be a sign which should alert the endoscopist to the presence of a choledochocele.
