Open AccessDouble major papilla: diagnostic challenge of an unusual anatomical variant
Author(s) -
Clara Amiama Roig,
R. Martos,
Eduardo Arranz,
Rafael Rey Sanz
Publication year - 2022
Publication title -
revista española de enfermedades digestivas/revista española de enfermedades digestivas
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.331
H-Index - 38
eISSN - 2340-4167
pISSN - 1130-0108
DOI - 10.17235/reed.2022.9184/2022
Subject(s) - medicine , major duodenal papilla , endoscopic retrograde cholangiopancreatography , common bile duct , fistula , radiology , duct (anatomy) , body orifice , general surgery , surgery , anatomy , pancreatitis
We report the endoscopic finding of a double papilla of Vater in a patient presenting choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP). The images showed the presence of two perfectly delimited papillary orifices, 1cm apart from each other. After cannulation of each orifice, we observed the Wirsung and the common bile duct (CBD) as completely independent ducts. Given the diagnostic challenge posed by this entity and the importance of differentiating it from a bilioenteric fistula, we believe it is worth knowing about it in order to manage it properly and to minimize secondary risks during the exploration.