Demonstrated anomalous pancreaticobiliary ductal junction

Abstract

Anomalies of the pancreaticobiliary junction are rare. Clinically anomalies of the pancreaticobiliary junction are uncommonly symptomatic but may present themselves with associated conditions ranging from benign acute abdominal pain to carcinomas. A 52 years old man was admitted to gastroenterology service with complaints of fever, nausea, vomiting and recurrent epigastric pain. He was diagnosed with biliary pancreatitis. Endoscopic retrograde cholangiopancreatography was performed. Papilla was not seen at its normal region. An ulcer was seen on posterior wall of bulbus. The orifice which was seen at the opposite side of ulcer was canalized. It was understood that it was orifice of the choleduct. Choleduct was shorter than normal. A second orifice was seen below the choleduct orifice. It was canalized and understood that it was pancreatic canal orifice. Pancreaticobiliary junction anomalies may present with recurrent abdominal pain, nausea and vomiting as seen in our case.