A CASE OF INTRADIVERTICULAR ACCESSORY PAPILLA WITH PANCREAS DIVISUM

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  • 膵管癒合不全を伴った十二指腸憩室内副乳頭の１例

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Abstract

There have been many reports on the major papilla in the duodenal diverticulum. However, we rarely encountered reports on the minor papilla in the duodenal diverticulum. A 88-year-old woman was admitted to our hospital to the further evaluation of the common bile duct dilatation with abdominal ultrasonography. MRCP reveals dilatation of the common bile duct, short ventral duct and long dorsal duct. ERCP disclosed that a large diverticulum was in the cranial side of the major papilla, and a minor papilla lie in the floor of the diverticulum. Endoscopic pancreatogram via the major papilla showed a short ventral duct with harmonious terminal arborization. Dorsal catheteriza-tion was attempted via the minor papilla and no communication was seen between the ventral and dorsal duct. This patient was diagnosed as pancreas divisum. This case may suggest the involvement of congenital factor, including abnormalities in the development of f oregut in the embryonal stage, and local fragility of duodenal wall. This paper discussed the significance and development of duodenal intradiverticular minor papilla.

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