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KMID : 0882420110810010093
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Korean Journal of Medicine
2011 Volume.81 No. 1 p.93 ~ p.97
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Intraductal Papillary Mucinous Neoplasm of the Bile Ducts Accompanied by a Choledochoduodenal Fistula
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Kim Hyung-Tae
Kim Sa-Il
Kwon Oh-Wan
Lee Hang-Rak
Jun Dae-Won
Lee Oh-Young
Choi Ho-Soon
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Abstract
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An intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B) is an uncommon tumor characterized by the secretion of large amounts of mucin and intraductal growth. The characteristic clinical symptoms and radiologic findings are due to bile-duct obstruction caused by mucin. A parapapillary choledochoduodenal fistula is a rare disorder. This fistula has no clinical symptoms and is diagnosed by chance. We report a case of parapapillary choledochoduodenal fistula associated with IPMN-B. A 63-year-old woman was admitted to Hanyang University Hospital because of jaundice. Computed tomography (CT) showed diffuse intra- and extrahepatic bile duct dilatation. The ducts were filled with heterogenous material. Duodenoscopy revealed a large choledochoduodenal fistula. Endoscopic retrograde cholangiography through the fistula showed a papillary mass in the common hepatic duct. IPMN-B with choledochoduodenal fistula was diagnosed. The patient underwent a left hepatectomy. Her postoperative course was uneventful, and she was observed regularly in the outpatient department.
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KEYWORD
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Intraductal papillary mucinous neoplasm of the bile ducts, Biliary fistula
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