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Korean J Pancreas Biliary Tract > Volume 2(1):1997 > Article
The Korean Journal of Pancreas and Biliary Tract 1997;2(1):14-20.
조영제 주입후 팽창되는 유두(papilla)의 관찰: Choledochocele의 특징적 ERCP소견에 대한 연구
명승재, 김명환, 김연석, 유병무, 서동완, 이성구, 민영일
울산대학교 의과대학 서울중앙병원 소화기내과
Ballooning Papilla during Contrast Injection; A pathognomonic endoscopic finding of a choledochocele
Seung Jae Myung, Myung Hwan Kim, Yeon Suk Kim, Byeung Moo Yoo, Dong Wan Seo, Sung Koo Lee, Young Il Min
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding author:  Myung Hwan Kim,
Choledochocele is a rare abnormality involving the intramural segment of the common bile duct. Endoscopic retrograde cholangiopancreatography (ERCP) is essential to demonstrate a choledochocele. The aim of this study was to investigate the duodenoscopic and cholangiographic findings during ERCP examination.
Over a five ­year period, seventeen symptomatic patients (8 male, 9 female, age range 45-83 years) were identified as having choledochoceles. The diagnosis of choledochocele was made by both duodenoscopic and cholangiographic findings.
As a characteristic duodenoscopic finding, the enlarged bulging papilla was noted in 8 (47%) patients, whereas normal-appearing papilla was noted in 9 (53%) patients before the injection of contrast medium. However, in all 17 patients progressive enlargement or ballooning of the papilla was noted during contrast injection. As a characteristic cholangiographic finding, a round cyst-like, contrast­filled structure was identified in all patients adjacent to the termination of common bile duct. The longest diameter of the choledochocele, determined by cholangiography, was significantly larger (19±4 mm) in patients with initially bulging papilla than in those with normal-appearing papilla (9±3 mm)(p<0.05). Conclusion: These results suggest that ballooning papilla during contrast injection may be a pathognomonic duodenoscopic finding for the diagnosis of a choledochocele. To avoid missing a choledochocele, to watch the papilla carefully during contrast injection may be very important.
Keywords: Choledochocele, Endoscopic retrograde cholangiopancreatography
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