Year 2023 / Volume 115 / Number 5
Letter
Double major papilla: diagnostic challenge of an unusual anatomical variant

273-274

DOI: 10.17235/reed.2022.9184/2022

Clara Amiama Roig, Rubén Fernández Martos, Eduardo Martín Arranz, Rafael Rey Sanz,

Abstract
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.
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References
1. Katsinelos P, Chatzimavroudis G, Fasoulas K, et al. Double major papilla of Vater - A rare endoscopic finding during endoscopic retrograde cholangiopancreatography: A case report. Cases J. 2009;2(10):1–3.
2. Simon MA, Moreira VF, Meroño E, et al. The double papilla of Vater. Gastrointest Endosc. 1985;31(5):353–4.
3. Katsarelias D, Faisal M, Glavas R, et al. Double papilla of Vater: A rare anatomic variant. Endoscopy. 2016;48:E133–4.
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Amiama Roig C, Fernández Martos R, Martín Arranz E, Rey Sanz R. Double major papilla: diagnostic challenge of an unusual anatomical variant. 9184/2022


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Publication history

Received: 04/09/2022

Accepted: 05/09/2022

Online First: 23/09/2022

Published: 05/05/2023

Article Online First time: 19 days

Article editing time: 243 days


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