Abstract

Variants of hepatic duct anomalies are widely discussed in the literature. Duplication producing a double and/or aberrant extrahepatic bile duct is one of the rarest congenital variants that have been sparingly reported. A 71-year-old female presented with right-sided abdominal pain. Computerized tomography demonstrated an enhancing soft tissue thickening in the gastric pylorus with extension into the left lobe of the liver and invasion of the left intrahepatic bile ducts and dilatation of the left intra- and extrahepatic biliary tract. Further examination led to a diagnosis of a double common bile duct with ectopic drainage into the gastric antrum. Recognition of this rare anomaly is of great importance because of the implications in respect of concomitant pathology, the potential short- and long-term sequelae and crucially for operative planning. Failing to appreciate the extent of anomalies may result in significant complications with the attendant morbidity.

CONCLUSION

Accurate and detailed knowledge of the biliary anatomy and its variations are essential for preoperative planning to minimize postoperative complications. Awareness of the possibility of these major and complex anomalies should increase their reported incidence and decrease the potentially severe associated morbidity and mortality. Where the anomalies are extensive, associated with ectopic drainage and chronic ref lux, the associated risk of malignancy must be appreciated, and the surgical procedure and consequent surveillance modified to obviate the consequences.