부산대학교 도서관

An 80-year-old-man was admitted because of acute cholecystitis, and PTGBD was performed. However, 6 days later, he presented with abdominal pain and jaundice. CT revealed a 30 mm-sized polycystic lesion at the pancreas head and the main pancreatic duct (MPD) dilated up to 8 mm in diameter. Duodenoscopy showed mucus discharge from the enlarged papilla of Vater. ERCP showed mucus in the dilated MPD regurgitated into the common bile duct (CBD) through the common channel. On EUS, there seemed to be a fistula between the CBD and the pancreatic cysts. Pancreaticoduodenectomy was performed. The resected specimen was histologically diagnosed as IPMN with high-grade dysplasia, and revealed no evidence of fistulization to the CBD. Thus, we concluded that mucus regurgitation into the CBD was likely to have caused jaundice in this case.