A CASE OF DUPLICATION OF THE COMMON BILEDUCT, EMPTYING INTO THE STOMACH

This paper describes a very uncommon case of duplication of the common bile duct, empting into the stomach, and an anomaly of superior mesenteric artery branching off celiac artery. A 68-year-old man presented with upper abdominal pain. Under a preoperative diagnosis of submucosal tumor of the angular notch of the stomach, laparotomy was carried out. During surgery the site diagnosed as the submucosal tumor was found to be the orifice of the ectopic bile duct, which was different from the common bile duct and reached to the angular notch from the bile duct of portahepatis. There was a pure pigment stone in the ectopic bile duct. No malposition of the extrahepatic bile duct and gallbladder was observed. No anomalous arrangement of pancreatobiliary duct was also noted. Cholelithotomy and T-tube drainage were performed for the ectopic bile duct, and gastrostomy was also done to confirm the orifice. This case demonstrated that duplication of the common bile duct empting into the stomach should be considered in the differential diagnosis of submucosal tumor of the stomach. A review of the literature in terms of the mechanisms of duplication of the common bile duct, branching morphology, and therapies is also presented here.