Aberrant Opening of the Common Bile Duct with Precancerous Change / 대한췌담도학회지

ABSTRACT

A 43-year-old male was admitted to our hospital via emergency room with epigastric pain for 3 days. Abdominal computed tomography revealed pneumobilia in the biliary tree. Endoscopic retrograde cholangiopancreatography showed an atypical location of ampulla of Vater (AOV) with duodenal deformity. The plastic stent was placed through the fistular opening at the upper mound of AOV for biliary decompression. He was rehospitalized due to aggravation of jaundice two weeks later. The previous stent was changed into the nasobiliary catheter and biopsy was done around the ectopic opening. He underwent Whipple's operation due to the high grade dysplasia on biopsy. This is the report of aberrant opening of the common bile duct (CBD) into the duodenal bulb with precancerous conditions. Therefore, endoscopic biopsy is recommended in patients with mucosal abnormality around the ectopic opening of the CBD.