DOI: 10.36347/sasjm.2023.v09i09.017

Pages: 1004-1008

Introduction: Choledococele is a rare congenital abnormality involving the intramural segment of the common bile duct. We report the case of a patient presenting with acute pancreatitis who was diagnosed with choledochocele. Case report: A 17-year-old boy, with a history of hospitalization 2 years ago for acute pancreatitis stage E, admitted for acute epigastralgia radiating to the back with notion of vomiting. Abdominal examination revealed epigastric tenderness without other abnormalities. Laboratory data reported leukocystosis (WBC: 16000/ul); elevated CRP at 111 mg/l; elevated Lipase at 412 IU/L. Abdominal CT scan shows stage D pancreatitis with an intra duodenal cystic formation in front of the ampulla of Vater suggesting a choledochocele. Abdominal MRI demonstrated a cystic dilatation of the lower bile duct classified as Todani type III. Echo endoscopy was performed indicating an ampullary cystic formation measuring 22,8x15,3mm which continues with the CBD evoking a choledocal cyst with presence of stones in intra-cystic. As a result of these findings, the patient was diagnosed with acute pancreatitis secondary to intraduodenal choledochocele. He had surgery with resection of the choledochocele. Conclusion: Choledococele is extremely rare. The diagnosis is facilitated by advances in imaging. Management and therapeutic choice are not yet consensual regarding radical surgical treatment or conservative endoscopic treatment.