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Double common bile duct: A case report

World Journal of Gastroenterology 2007年第27期13卷 3770-3772页

作者： Srdjan P Djuranovic milenko b ugljesic Nenad S Mijalkovic Viktorija A Korneti Nada V Kovacevic Tamara M Alempijevic Slaven V Radulovic Dragan V Tomic Milan M Spuran Clinic for Gastroenterology and Hepatology Clinical Center of Serbia Belgrade Serbia 1st Surgical Clinic Clinical Center of Serbia Belgrade Serbia

Double common bile duct （DCbD） is a rare congenital anomaly in which two common bile ducts exist. One usually has normal drainage into the papilla duodeni major and the other usually named accessory common bile duct （ACbD） opens in different parts of upper gastrointestinal tract （stomach, duodenum, ductus pancreaticus or septum）. This anomaly is of great importance since it is often associated with biliary lithiasis, choledochal cyst, anomalous pancreaticobiliary junction （APbJ） and upper gastrointestinal tract malignancies. We recently recognized a rare case of DCbD associated with APb3 with lithiasis in better developed common bile duct. The opening site of ACbD was in the pancreatic duct. The anomaly was suspected by transabdominal ultrasonography and finally confirmed by endoscopic retrograde cholangiopancreatography （ERCP） followed by endoscopic sphincterotomy and stone extraction. According to the literature, the existence of DCbD with the opening of ACbD in the pancreatic duct is most frequently associated with APb3 and gallbladder carcinoma. In case of DCbD, the opening site of ACbD is of greatest clinical importance because of its close implications with concomitant pathology. The adequate diagnosis of this rare anomaly is significant since the operative complications may occur in cases with DCbD which is not recognized prior to surgical treatment.

关键词： Double common bile duct Accessory common bile duct Anomalous pancreaticobiliary junction

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EUS diagnosis of ectopic opening of the common bile duct in the duodenal bulb: A case report

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World Journal of Gastroenterology 2005年第32期11卷 5068-5071页

作者： Miodrag Krstic bojan Stimec Radmilo Krstic milenko ugljesic Srbislav Knezevic Ivan Jovanovic Clinical Center of Serbiabelgrade Serbia and Montenegro Institute for AnatomySchool of Medicine BelgradeSerbia and Montenegro

Among the various congenital anomalies of the biliary system,an ectopic opening of the common bile duct (CbD) in the duodenal bulb is extremely rare. ERCP is essential for diagnosing the anomaly. A 55-year-old male was admitted to hospital for severe right upper quadrant abdominal pain,followed by fever, chills, elevated body temperature and mild icterus. The diagnosis of ectopic opening of CbD in the duodenal bulb was established on endoscopic ultraso-nography (EUS),which clearly demonstrated dilated CbD, with multiple stones and air in the lumen, draining into the bulb. A normal pancreatic duct, which did not drain into the bulb, was also observed. This finding was confirmed on ERCP and *** far as we know, this is the first case of this anomaly diagnosed by EUS. Ectopic opening of the CbD in the duodenal bulb is not an incidental finding, but a pathologic condition which can be associated with clinical entities such as recurrent or intractable duodenal ulcer, recurrent biliary pain,choledocholithiasis or acute cholangitis. Endoscopic ultrasonography features allow preoperative diagnosis of this anomaly and can replace ERCP as a first diagnostic tool in such clinical circumstances. Embryology of the anomalies of the extrahepatic biliary tree has been also reviewed.

关键词： Ectopic opening Common bile duct Congenital anomaly Endoscopic ultrasound

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Mucinous cystadenoma of the appendix associated with adenocarcinoma of the sigmoid colon and hepatocellular carcinoma of the liver:Report of a case

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World Journal of Gastroenterology 2006年第12期12卷 1975-1977页

作者： Srdjan P Djuranovic Milan M Spuran Nada V Kovacevic milenko b Uqliesic Dragutin M Kecmanovic Marian T Micev Institute for Digestive Diseases Clinical Center of SerbiaK.Todorovica St No 611000 BelgradeSerbia and Montenegro

Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups： focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liven Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.

关键词： Hucocele Appendiceal cystadenoma Colon carcinoma Hepatocellular carcinoma

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