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Mucin-filled CBD, difficult to manage cholangitis
  1. Manish Kumar,
  2. Ujjwal Sonika,
  3. Sanjeev Sachdeva and
  4. Ashok Dalal
  1. Gastroenterology, GB Pant Hospital, New Delhi, India
  1. Correspondence to Dr Ashok Dalal; drashokdalal83{at}


Intraductal papillary mucinous neoplasms (IPMNs) are mucin-secreting cystic neoplasm of pancreas. They have a malignant potential. They are usually localised to the pancreas but occasionally can involve surrounding structures (1.9%–6.6%), like bile duct and duodenum, and are labelled as IPMN with invasion. Jaundice as a manifestation of IPMN is not common (4.5%). It can present as jaundice as a result of invasion of common bile duct (CBD) resulting in stricture formation or uncommonly as a result of fistulising to CBD with resultant obstruction of CBD by thick mucin secreted by this tumour. As only few cases (around 23) of mucin-filled CBD are reported in the literature. We are presenting our experience in dealing a rare case of obstructive jaundice caused by IPMN fistulising into CBD, highlighting the difficulties faced in managing such case, especially with regards to biliary drainage and what can be the optimum management in such cases.

  • pancreas and biliary tract
  • endoscopy

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  • Contributors MK: drafting the article, acquisition of data or analysis and interpretation of data. US: revising it critically for important intellectual content. SS: revising it critically for important intellectual content. AD: conception and design and interpretation of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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