Presentation
Jaundice, high levels of direct bilirubin.
Patient Data
Mildly dilated intrahepatic and extrahepatic biliary ducts (CBD - 1.0cm). In the biliary system, stones or mass aren't seen. At the 2nd part of the duodenum, there is seen an air-filled outpouching (periampullary diverticulum), that compresses the distal CBD. The gallbladder is removed.
Case Discussion
Duodenal diverticula are found in 27% of patients undergoing upper gastrointestinal examination. Periampullary diverticula (PAD) is the most common type. Although PAD does not usually provoke symptoms, it can be a source of obstructive jaundice even without choledocholithiasis or tumor.