A complex pancreaticobiliary malunion causing recurrent pancreatitis in a boy: A case report
Keywords:Congenital pancreaticobiliary maljunction, Pancreatolithiasis, Pancreaticobiliary reflux
Pancreaticobiliary malunion (PBM) is a distinct malformation of the pancreatic and biliary ductal system, in which the junction of the pancreatic and biliary ducts occurs above the duodenal wall. PBM has varied presentations that prompt early diagnosis and management.
A 9-year-old male, a known case of chronic pancreatitis, presented with sudden intense abdominal pain and vomiting. After evaluation, the diagnosis of acute on chronic pancreatitis secondary to PBM was made and the patient underwent Roux-en y hepaticojejunostomy, along with cholecystectomy and common bile duct excision.
The purpose of this report is to add to the literature the unique presentation of PBM in the pediatric population in order to aid in prompt diagnosis and management. This will be the first report on PBM in the pediatric population of Pakistan
Petrasek J, Hucl T, Spicak J. Pancreaticobiliary malunion and incomplete pancreas divisum: an unusual cause of common bile duct obstruction. Adv Med Sci [Internet]. 2008 [cited 2022 Jan 8]; 53(1):6–10.
Ataka R, Ito T, Masui T, Seo S, Ishii T, Ogiso S, et al. Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature. World J Hepatol [Internet]. 2019 [cited 2022 Jan 8]; 11(11):743–51.
Guo W-L, Huang S-G, Wang J, Sheng M, Fang L. Imaging findings in 75 pediatric patients with pancreaticobiliary maljunction: a retrospective case study. Pediatr Surg Int [Internet]. 2012 [cited 2022 Jan 8]; 28(10):983–8.
Song HK, Kim MH, Myung SJ, Lee SK, Kim HJ, Yoo KS, et al. Choledochal cyst associated with anomalous union of pancreaticobiliary duct (AUPBD) has a more grave clinical course than choledochal cyst alone. Korean J Intern Med [Internet]. 1999 [cited 2022 Jan 8]; 14(2):1–8.
Sugiura T, Endo T, Ito K, Goto K, Sato Y, Kondo S, et al. Recurrent cholangitis with congenital hepatic fibrosis and pancreaticobiliary maljunction after Roux-en-Y reconstruction. European J Pediatr Surg Rep [Internet]. 2013 [cited 2022 Jan 8]; 1(1):43–5.
Tanaka M. Diagnosis and management of pancreaticobiliary malunion. The Korean Journal of Pancreas and Biliary Tract [Internet]. [cited 2022 Jan 8]; 7(1):47–9.
Kamisawa T, Ando H, Suyama M, Shimada M, Morine Y, Shimada H, et al. Japanese clinical practice guidelines for pancreaticobiliary maljunction. J Gastroenterol [Internet]. 2012 [cited 2022 Jan 8]; 47(7):731–59.
Larsen M, Kozarek R. Management of pancreatic ductal leaks and fistulae: Pancreatic leak management. J Gastroenterol Hepatol [Internet]. 2014 [cited 2022 Jan 8]; 29(7):1360–70.
Matsumoto Y, Fujii H, Itakura J, Matsuda M, Nobukawa B, Suda K. Recent advances in pancreaticobiliary maljunction. J Hepatobiliary Pancreat Surg [Internet]. 2002 [cited 2022 Jan 8];9(1):45–54.
How to Cite
Copyright (c) 2022 Amen Zafar, Anwar Ul Haq, Dawood Shehzad, Mohammad Salih, Gulrez Umar
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.