Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 1;25(10):706-711.
doi: 10.34172/aim.2022.110.

Ectopic Opening of Common Bile Duct into Duodenal Bulb and Gastric Antrum and Its Importance

Ümit Karabulut  1 , Ali Üzel  1 , Ramazan Yolaçan  1 , Feyzullah Uçmak  1 , Muhsin Kaya  1
Affiliations

Ectopic Opening of Common Bile Duct into Duodenal Bulb and Gastric Antrum and Its Importance

Ümit Karabulut et al. Arch Iran Med. .

Abstract

Background: Ectopic opening of the common bile duct (CBD) is extremely rare, and its importance has not been adequately defined. The aim of our study is to present the characteristics of patients with this abnormality.

Methods: This retrospective study was conducted in a tertiary center in Dicle University Hospital, Diyarbakır, Turkey, between October 2008 and December 2020. We present clinical, laboratory, endoscopic and cholangiographic features as well as the success rate of therapeutic interventions of consecutive patients with this abnormality undergoing endoscopic retrograde cholangiopancreatography (ERCP).

Results: Ectopic opening of the CBD was identified in 29 (21 men; mean age 62) out of 3872 (0.74%) patients. There was a history of cholecystectomy in 14 (48%) and recurrent acute cholangitis in 20 (69%) patients. We found peptic ulcer in 13 (45%) and duodenal deformity associated with apical stenosis in 21 (72%) patients. Opening site was seen as abnormal in all patients, and it opened into the antrum in 2 (6.8%) and into the first part of the duodenum in 27 (93%) patients. Copious amount of bile and/ or bile sediment in the stomach were seen in all patients. We observed dilatation in both intrahepatic and extrahepatic bile ducts together with tapered narrowing and a hook-shaped distal end of CBD in all patients. There was bile stone in 26 (89%) and sludge in 3 (10%) patients. Sphincterotomy was not performed in any patients because there was not enough incision distance. Balloon dilatation was performed for extraction of stone and sludge in all patients. Complete stone extraction was achieved in only 7 out of 26 (27%) patients.

Conclusion: Ectopic opening of CBD is usually associated with gastroduodenal and bile ducts disease. Endoscopic treatment is unsatisfactory in most patients with this abnormality.

Keywords: Cholangitis; Common bile duct; Ectopic opening.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3
Figure 4
Figure 4
Figure 5
Figure 5
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Disibeyaz S, Parlak E, Cicek B, Cengiz C, Kuran SO, Oguz D, et al. Anomalous opening of the common bile duct into the duodenal bulb: endoscopic treatment. BMC Gastroenterol. 2007;7:26. doi: 10.1186/1471-230x-7-26. - DOI - PMC - PubMed
    1. Lee HJ, Ha HK, Kim MH, Jeong YK, Kim PN, Lee MG, et al. ERCP and CT findings of ectopic drainage of the common bile duct into the duodenal bulb. AJR Am J Roentgenol. 1997;169(2):517–20. doi: 10.2214/ajr.169.2.9242767. - DOI - PubMed
    1. Lee SS, Kim MH, Lee SK, Kim KP, Kim HJ, Bae JS, et al. Ectopic opening of the common bile duct in the duodenal bulb: clinical implications. Gastrointest Endosc. 2003;57(6):679–82. doi: 10.1067/mge.2003.210. - DOI - PubMed
    1. Sezgin O, Altintaş E, Uçbilek E. Ectopic opening of the common bile duct into various sites of the upper digestive tract: a case series. Gastrointest Endosc. 2010;72(1):198–203. doi: 10.1016/j.gie.2010.02.012. - DOI - PubMed
    1. Sezgın O, Altintaş E, Uçbılek E. Ectopic opening of the common bile duct into the stomach. Turk J Gastroenterol. 2010;21(2):163–7. doi: 10.4318/tjg.2010.0076. - DOI - PubMed