Duplication of common bile duct

Case contributed by Dr Husam Hussein Yaseen

Presentation

Abdominal pain

Patient Data

Age: 60 years
Gender: Female

Pre and post-contrast studies show dilated intra and extra-hepatic biliary trees caused by intra-biliary rupture of the hepatic hydatid cyst. The CBD form by two separated extra-hepatic ducts that are united as a short common trunk distally features consistent with type Va duplication of the common bile duct.
The liver margin is irregular with dilated portal vein and splenomegaly (changes of chronic liver disease).
The gall bladder was surgically removed.

The image shows a direct communication of hepatic hydatid cyst (yellow arrow) to the biliary tree (orange arrowheads). 
The CBD form by two separated drainers of the left and the right intrahepatic biliary tree (violet arrows) that united in a common trunk.

Case Discussion

The thick obstructing content of the ruptured hydatid cyst clarified this anomaly which is hard to catch in a non dilated duct.

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