Abstract

LOPEZ GROVE, Roy; AINESEDER, Martina; OSSANA, María Jimena  and  SPINA, Juan Carlos. Pancreaticobiliary maljunction: a rare entity in the West. Rev. argent. radiol. [online]. 2021, vol.85, n.3, pp.62-67.  Epub Feb 04, 2021. ISSN 1852-9992.  http://dx.doi.org/10.1055/s-0040-1721341.

Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and biliary ducts are anatomically joined outside the duodenal wall. Due to the excessive length of the common channel, the action of the sphincter does not affect the pancreaticobiliary junction, allowing the reflux of pancreatic juice into the bile duct. It is associated with cysts of the common bile duct and its manifestations include cancer of the bile duct, pancreatitis, choledocholithiasis and cholangitis. It is a rare pathology, especially in Western countries.

Magnetic resonance cholangiopancreatography (MRCP) has become the most used method because it is non-invasive, taking into account that endoscopic retrograde cholangiopancreatography (ERCP) is contraindicated in cases of acute pancreatitis and cholangitis, in addition to the risk of pancreatitis after the procedure.

The distance between the biliopancreatic junction and the duodenal wall must be greater than 9 mm in length to diagnose PBM by MRCP. If it is between 6 to 9 mm and the action of the sphincter affects the pancreaticobiliary junction, it is called high confluence of pancreaticobiliary ducts (HCPBD) and should be confirmed by ERCP.

We describe the imaging findings of 7 young patients with abdominal symptoms and diagnosis of PBM or HCPBD by MRCP, and also review the literature on the subject.

Keywords : Pancreaticobiliary maljunction; Magnetic resonance cholangiopancreatography; Biliary tract; Pancreas.

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