Korean J Med > Volume 75(6); 2008 > Article
The Korean Journal of Medicine 2008;75(6):685-688.
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
토혈을 동반한 총담관의 이소성 개구
정지현, 이태희, 양성욱, 김성민, 김선문, 임의혁, 허규찬
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)
Key Words: Ectopic common bile duct; Ulcer; Hematemesis


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