Endoscopic Ultrasound-Guided Detection of a Rare Anomaly-Duplication of Extrahepatic Bile Duct

This is the first reported case demonstrating endoscopic ultrasound (EUS) findings in type Va duplication. The malformation of the congenital extrahepatic bile duct is classified as type Va and is rarely observed. To date, not more than 30 cases have been reported in Western literature. For the medical literature, a 50-year-old man with a type Va extrahepatic bile duct obstruction is examined. He presented with abdominal pain and jaundice, and imaging showed biliary dilatation and cholelithiasis. During the EUS procedure, an endoscopic examination revealed the presence of a duplicated common bile duct with a septum. Endoscopic retrograde cholangiopancreatography of the biliary tract also showed the same anomaly, with the presence of obstructive biliary sludge. The case highlights the need to consider EUS as a potent alternative diagnostic method. It is important to detect these anomalies immediately to reduce the chances of endoscopic/surgical complications.