Complex pancreaticobiliary maljunction diagnosed by endoscopic ultrasound: A case report
Year: 2024
Type: article
Study design: Case Report
Abstract: RATIONALE: This case report aims to enhance understanding of pancreatobiliary maljunction (PBM) and promote more proactive treatment. PATIENT CONCERNS: The patient, a 24-year-old Chinese female, was admitted to the hospital on April 7, 2020, due to "recurrent abdominal pain for over 2 years, with a recent episode accompanied by nausea and vomiting for 1 day." She had a previous history of gallstones. DIAGNOSES: The initial diagnosis upon admission was biliary acute pancreatitis. During the emergency endoscopic retrograde cholangiopancreatography (ERCP) procedure, anatomical abnormalities were discovered. Intraoperative endoscopic ultrasonography led to a diagnosis of complex PBM (JSPBM, type D) + choledochal cyst (Todani, Ic) + incomplete pancreatic divisum + early chronic pancreatitis. These diagnoses were confirmed by postoperative magnetic resonance cholangiopancreatography. INTERVENTIONS: After multiple conservative treatments such as ERCP with accessory pancreatic duct stent placement, the patient underwent surgical treatment in April 2021, which included "laparoscopic left hemihepatectomy + choledochal cyst excision + cholecystectomy + hepatic portal cholangioplasty." OUTCOMES: The patient has not experienced any abdominal pain since the surgery and is currently under regular follow-up. LESSONS: Endoscopic ultrasound is effective for the diagnoses of complex PBM and incomplete pancreatic divisum. ERCP with pancreatic duct stent placement and surgical procedure is reliable for relieving the patient's symptoms.
Source: Medicine
Authors: Wen Xu, Yang Lv, Ying Zhu, Yingchun Zhang, Wei Gong, Xiaobing Cui
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,950
OpenAlex ID: W4405429175