An. Dalvi et al., Incomplete pancreas divisum with anomalous choledochopancreatic duct junction with choledochal cyst, ARCH SURG, 134(10), 1999, pp. 1150-1152
The coexistence of incomplete pancreas divisum, an anomalous choledochopanc
reatic duct junction, and a choledochal cyst is an extremely rare condition
, described in only 3 patients in the available medical literature. The sym
ptoms may be similar to any of these 3 distinct pathological conditions. Ma
gnetic resonance cholangiopancreatography or endoscopic retrograde cholangi
opancreatography is usually required for diagnosis. Management of symptomat
ic pancreas divisum may be accomplished with open accessory duct sphinctero
plasty or endoscopic papillotomy with or without stenting. Treatment of cho
ledochal cyst is by complete excision of the cyst whenever possible, with h
epaticodochoenterostomy being the treatment of choice. Here, we describe a
patient with this complex disorder who was successfully managed with endosc
opic minor duct papillotomy with accessory pancreatic duct stenting and res
ection of the choledochal cyst with hepaticodochojejunostomy.