Congenital agenesis of the common bile duct

Excerpt

Anterior (a) and posterior (b) views of volume-rendered magnetic resonance cholangiopancreatography images in a 13-year-old boy with recurrent jaundice show non-visualisation of the common bile duct (CBD) with dilated left (black arrowhead) and right (white arrowhead) hepatic ducts. The inferior branch of the right anterior sectoral duct connects to the gallbladder (thick white arrow), which in turn directly opens (broken arrow) into the first part of the duodenum (asterisk). Sectoral branches of the left hepatic duct, superior branch of the right anterior sectoral duct (thin white arrow), right posterior sectoral duct, and its superior (white chevron) and inferior (black chevron) branches are normal. A diagnosis of congenital agenesis of the CBD with persistent hepatico-cholecystic duct and cystic ducts opening into the duodenum was made. Treatment involved cholecystectomy, ligation of the anterior branch of the right anterior sectoral duct, and Roux-en-Y choledochojejunostomy. Congenital absence of the CBD is rare and occurs secondary to persistent connections between the fetal hepatic ducts and gallbladder with failure of complete recanalization of the extrahepatic biliary tract.

…