title: A case of pancreaticobiliary maljunction with a connecting duct without a long common channel.
abstract: Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall, usually forming an abnormally long common channel. In PBM, since the long common channel defeats the effect of the sphincter of Oddi, pancreatobiliary reflux frequently occurs, resulting in high rates of biliary tract cancers. We present the case of a 68-year-old female with advanced gallbladder cancer concomitant with bile duct cancer associated with PBM without biliary dilatation that had an extremely rare configuration showing a connecting duct without a long common channel. Pancreatography in the selectively cannulated main pancreatic duct showed the terminal portion of the common bile duct via an abnormal connecting duct. Cholangiography in the selectively cannulated lower bile duct showed the main and accessory pancreatic ducts via the connecting duct. The bile amylase level was markedly elevated. This case of a rare configuration of PBM with a connecting duct without a long common channel is the first such reported case in the English literature.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Kikuyama
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. kamisawa@cick.jp.
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Kuruma
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Kazuro
authors.initials: K
authors.lastname: Chiba
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Koizumi
authors.affiliation: Department of Endoscopy, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Tabata
authors.affiliation: Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Honda
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D049448:Cholangiopancreatography, Magnetic Resonance; D003135:Common Bile Duct / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000209:etiology; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
keywords: Anomalous connection; Common channel; Pancreaticobiliary maljunction