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一名男性患者中Ⅴ型双胆总管的存在:病例报告

The Presence of Type Va Double Common Bile Duct in a Male Patient: A Case Report.

作者信息

McDermott Jamie, Gonzalez Shakira E, Medina Alonso Zurisadai, Oquendo Figueroa Julio A, Nunez April, Ahmed Imtiaz

机构信息

Medicine, Midwestern University Arizona College of Osteopathic Medicine, Glendale, USA.

Medicine, Universidad Autonoma de Guadalajara, Guadalajara, MEX.

出版信息

Cureus. 2024 Oct 31;16(10):e72801. doi: 10.7759/cureus.72801. eCollection 2024 Oct.

DOI:10.7759/cureus.72801
PMID:39618641
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11608289/
Abstract

Double common bile duct (DCBD) is a rare congenital anomaly of the biliary system, characterized by the presence of two common bile ducts. The condition can be classified into five distinct types. Type Va DCBD is one of the rare congenital variations where both bile ducts open separately into the duodenum: one opens normally at the major duodenal papilla, and the second opens independently into the duodenum at a different site, usually proximal to the major duodenal papilla. DCBD is often associated with biliary pathologies such as cholelithiasis, choledocholithiasis, choledochal cysts, abnormal pancreaticobiliary junction (APBJ), and upper gastrointestinal malignancies. We present the case of an 83-year-old male from the United States who presented to the emergency department with right upper quadrant (RUQ) pain. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) revealed a type Va DCBD, complicated by cholelithiasis and acute calculous cholecystitis. The patient underwent a laparoscopic cholecystectomy, along with common bile duct stent placement for biliary drainage. This case highlights the importance of identifying atypical radiologic features indicative of rare congenital biliary anomalies such as type Va DCBD. Given the scarcity of reported cases in the literature, accurate preoperative imaging and early diagnosis of this anomaly are crucial for preventing long-term complications and guiding appropriate surgical management.

摘要

双胆总管(DCBD)是一种罕见的先天性胆道系统异常,其特征为存在两条胆总管。这种情况可分为五种不同类型。Va型DCBD是罕见的先天性变异之一,两条胆管分别开口于十二指肠:一条正常开口于十二指肠大乳头,另一条在不同部位独立开口于十二指肠,通常在十二指肠大乳头近端。DCBD常与胆石症、胆总管结石、胆总管囊肿、胰胆管异常汇合(APBJ)和上消化道恶性肿瘤等胆道疾病相关。我们报告一例来自美国的83岁男性患者,因右上腹(RUQ)疼痛就诊于急诊科。磁共振胆胰管造影(MRCP)和内镜逆行胰胆管造影(ERCP)显示为Va型DCBD,并伴有胆石症和急性结石性胆囊炎。患者接受了腹腔镜胆囊切除术,并放置了胆总管支架进行胆道引流。该病例强调了识别指示罕见先天性胆道异常(如Va型DCBD)的非典型影像学特征的重要性。鉴于文献中报道的病例稀少,准确的术前影像学检查和对这种异常的早期诊断对于预防长期并发症和指导适当的手术管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f825/11608289/8d607b8d8058/cureus-0016-00000072801-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f825/11608289/19014f53c683/cureus-0016-00000072801-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f825/11608289/8d607b8d8058/cureus-0016-00000072801-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f825/11608289/19014f53c683/cureus-0016-00000072801-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f825/11608289/8d607b8d8058/cureus-0016-00000072801-i02.jpg

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本文引用的文献

1
A proposed feasible classification of common bile duct duplications based on a newly described variant and review of existing literature.基于一种新描述的变异型和对现有文献的回顾,提出一种可行的胆总管重复畸形的分类方法。
BMC Pediatr. 2022 Nov 8;22(1):647. doi: 10.1186/s12887-022-03708-1.
2
Double common bile duct with cholelithiasis.双胆总管伴胆结石。
J Minim Access Surg. 2023 Apr-Jun;19(2):307-309. doi: 10.4103/jmas.jmas_85_22.
3
Double common bile duct associated with pancreaticobiliary maljunction.双重胆总管与胰胆管合流异常相关。
Nagoya J Med Sci. 2021 Aug;83(3):655-661. doi: 10.18999/nagjms.83.3.655.
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A Review of Double Common Bile Duct and Its Sequelae.双胆总管及其后遗症综述
Gastroenterology Res. 2018 Feb;11(1):1-4. doi: 10.14740/gr950w. Epub 2018 Feb 23.
5
Duplication of the extrahepatic bile duct: A case report and review of the literatures.肝外胆管重复畸形:1例病例报告并文献复习
Medicine (Baltimore). 2018 Feb;97(8):e9953. doi: 10.1097/MD.0000000000009953.
6
Double common bile duct with an ectopic drainage into the stomach.双胆总管伴异位引流至胃。
Ann Surg Treat Res. 2015 Apr;88(4):229-31. doi: 10.4174/astr.2015.88.4.229. Epub 2015 Mar 26.
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Common bile duct duplication: the more the murkier.胆总管重复畸形:情况越复杂越模糊不清。
Saudi J Gastroenterol. 2015 Jan-Feb;21(1):51-4. doi: 10.4103/1319-3767.151231.
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Duplication of the extrahepatic bile duct with anomalous union of the pancreaticobiliary ductal system revealed by MR cholangiopancreatography.磁共振胰胆管造影显示肝外胆管重复畸形合并胰胆管系统异常汇合。
Br J Radiol. 2007 Jul;80(955):e150-4. doi: 10.1259/bjr/50929809.
9
Double common bile duct: a case report.双胆总管:一例报告。
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