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The Korean Journal of Medicine 2008;75(6): 685-688.
토혈을 동반한 총담관의 이소성 개구
정지현, 이태희, 양성욱, 김성민, 김선문, 임의혁, 허규찬
A case of ectopic opening of the common bile duct (CBD) associated with hematemesis
Ji Hyun Jeong, Tae Hee Lee, Seong Wook Yang, , , ,
성균관 의과대학교 삼성서울병원 심혈관센터 순환기내과
ABSTRACT
Ectopic opening of the common bile duct (CBD) in the duodenal bulb is not an incidental finding, but a pathologic condition that can be associated with clinical entities, such as recurrent duodenal ulcer, choledocholithiasis. or cholangitis. We report a case of ectopic CBD with hematemesis in a 61 year-old male patient. Esophagogastroduodenoscopy showed several active ulcers with a fresh blood clot at the duodenal bulb, which had a mucosal deformity and a small opening with suspicious drainage of bile, and the second part of the duodenum had no papilla-like structure. MRCP showed a trident-like pancreatobiliary tree. The biliary tree was visualized via a suspicious ectopic opening of the bile duct at the duodenal bulb. The distal CBD looked hook-shaped and had no filling defect. We report a unique case of ectopic opening of the CBD in the duodenal bulb, which presented as hematemesis. (Korean J Med 75:685-688, 2008)
Keywords: Ectopic common bile duct; Ulcer; Hematemesis
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