title: Extra-hepatic biliary-ductal necrosis following acute pancreatitis: 10 years of follow-up.
abstract: This case report is 10 years follow-up of a child who presented with acute abdomen at the age of 8 years. Exploration revealed acute pancreatitis with the necrosis of common bile duct and almost whole of the common hepatic duct with bile leaking from the junctional stump of the right and left hepatic ducts. The patient was managed successfully by Roux-en-Y hepaticojejunostomy. After 10 years, the patient again presented with a recurrent discharging sinus from the anterior abdominal wall. On exploration, it was found to be a stitch granuloma near the site of hepaticojejunostomy. However, hepaticojejunostomy was found to function normally as seen on MRCP. This rare case highlights that extra-hepatic biliary-ductal necrosis is very unusual complication of acute pancreatitis; and it can be successfully managed by Roux-en-Y hepaticojejunostomy as evident from long-term follow-up.
authors.affiliation: Post-graduate Institute of Medical Sciences, Rohtak, Haryana, India. drsanjay.marwah@gmail.com
authors.forename: Sanjay
authors.initials: S
authors.lastname: Marwah
authors.forename: R B
authors.initials: RB
authors.lastname: Singh
authors.forename: Sham
authors.initials: S
authors.lastname: Singla
authors.forename: Nisha
authors.initials: N
authors.lastname: Marwah
mesh_terms: D000293:Adolescent; D001649:Bile Duct Diseases / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000473:pathology*; D003135:Common Bile Duct / Q000473:pathology; D005500:Follow-Up Studies; D006099:Granuloma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006500:Hepatic Duct, Common / Q000473:pathology; D006801:Humans; D008297:Male; D009336:Necrosis; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000601:surgery*; D011171:Portoenterostomy, Hepatic / Q000009:adverse effects*; D011183:Postoperative Complications; D013537:Sutures / Q000009:adverse effects