Choosing the correct path: the double orifice papilla

A 74-year-old woman with rheumatoid arthritis experienced cholestatic liver function. Abdominal US demonstrated intrahepatic and extrahepatic duct dilatation and gallstones in an enlarged gallbladder. Magnetic resonance cholangiography confirmed echogenic foci within a dilated common bile duct (CBD). ERCP revealed a double orifice major papilla (A). After careful assessment, the cranial orifice at 11 o ’clock was intubated, and a biliary cholangiogram confirmed gallstones in a dilated CBD (B). Sphincterotomy was performed, and a plastic stent was inserted for drainage (C), and the patient was given postprocedure intravenous antibiotic agents and rectal diazepam.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: At the focal point Source Type: research