Congenital dilatation of the common bile duct is a rare complication in pregnant woman. Eleven cases of congenital dilatation of the common bile duct in pregnancy are reviewed in Japanese literature, but only four cases were diagnosed at the antepartum stage. This report shows a case of congenital dilatation of the common bile duct complicated with acute pancreatitis in pregnancy.
A 24 year-old-woman, primigravida, was hospitalized for severe right upper quadrant pain and right upper quadrant tumor at the 32 th gestational week. She was diagnosed as congenital dilatation of common bile duct and acute pancreatitis using ultrasonic graphy. Elevated serum and urinary amylase levels were 2, 099 IU/L and 28, 237 IU/L. She had the conservative treatment of acute pancreatitis with a synthetic protease inhibitor (FOY), 300mg/day. Four days later, she delivered a still born baby weighing 2, 100g. After delivery, an abdominal CT demonstrated a large cystic tumor neighbouring a normal-sized gallbladder. And a percutaneus transhepatic cholangiogram (PTC) showed prominent dilatation of the common bile duct. Twenty seven days after delivery, cholecystectomy and choledochoduodenostomy were done.
Congenital dilatation of common bile duct is increasing in number. More incidents have been reported in females than males. Therefore, in the near future, congenital dilatation of the common bile duct may increase in pregnant cases.
It is necessary to have early recognition and rapid treatment. So the outcome of pregnancy complications, such as pancreatitis and cholangitis, is favorable.
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