Ectopic opening of the common bile duct into the duodenal bulb with recurrent choledocholithiasis: A case report

Figure 1 Endoscopic retrograde cholangiopancreatography images. A: The ectopic opening of the common bile duct into the duodenal bulb (white arrow); B: Injection of contrast medium through the ectopic opening of the common bile duct with acute angulation (orange arrow); C: Indwelling nasal bile duct after endoscopic treatment (orange arrow).

Figure 2 Magnetic resonance imaging findings. Magnetic resonance imaging showed a hook-shaped change at the lower end of the common bile duct, which merged into the lower posterior wall of the duodenal bulb. The orange arrow shows the hook shape.

Figure 3 Surgical procedure. A: Dissection of the extrahepatic bile duct (white arrow); B: Superficial common bile duct under the pylorus, which exhibited an ectopic opening into the duodenal bulb (white arrow); C: After incising the common bile duct and removing the stone, the nasal bile duct in the common bile duct was visible (white arrow); D: Excision of the extrahepatic bile duct and complete cholangiojejunostomy.