2020 Volume 34 Issue 2 Pages 188-193
We reported a case of choledochocele diagnosed by intraoperative cholangiography, which could not be found with MDCT, DIC-CT, MRCP and EUS. A 58-year-old woman visited a nearby hospital because of left lower abdominal pain and the main pancreatic duct dilatation was pointed out on CT. MRCP taken at another hospital demonstrated the possibility of pancreaticobiliary maljunction and she was referred to our hospital. On DIC-CT, both a common bile duct and a pancreatic duct were visualized, but a common channel and a communicating branch of both ducts were missing. Upper Gastrointestinal endoscopy showed the normal papilla of Vater. EUS showed the diffuse thickness of gallbladder wall and non-dilatation of the bile duct. As she denied consent to ERCP, we performed laparoscopic cholecystectomy and intraoperative cholangiography. Real-time fluoroscopic cholangiogram showed the cystic dilatation of the end of the bile duct, 10mm in diameter and subsequently revealed the pancreatic duct. Thus, we could make a diagnosis of choledochocele for the first time.
