A new variant of bile duct duplication with coexistence of distal cholangiocarcinoma.

ABSTRACT

BACKGROUND: A 72-year-old hypertensive woman presented with a 2-month history of right upper quadrant abdominal pain. She had a 15-day history of jaundice, fever with chills and shivering, nausea, vomiting, weight loss and generalized pruritus. INVESTIGATIONS Physical examination, laboratory evaluation, transabdominal ultrasonography, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, brush cytology, laparotomy and histopathology. DIAGNOSIS Bile duct duplication with coexistence of distal cholangiocarcinoma. MANAGEMENT En bloc resection (including the duodenum, pancreatic head and adjacent lymph nodes), hepaticojejunostomy and pylorus-saving Whipple operation.