Giant choledochocele presenting as intussusception (with video)

 CommentaryCan a choledochocoele be lined with duodenal mucosa and not lose its identity? Well, 63% of choledochocoeles in one study had such mucosa, and this type of evidence has led some authors to suggest that choledochocoeles, also known as Type III choledochal cysts, actually are duodenal duplications. Whether dilation involves the bile duct, common channel, or duodenal wall at the onset of the dilation process seems to me critical to determine the nature of the entity and also the complications to be expected over the ensuing decades. This case was particularly intriguing because of the windsock deformity the intussusceptum caused as it traveled down to the duodenojejunal junction, an example of the so-called diverticular choledochocoele. What is clear, however, is that these authors do not lack courage. Snare resection of a known diverticulum? Oh well, endoscopic sequelae can be viewed as opportunities for creative problem solving.Lawrence J. Brandt, MDAssociate Editor for Focal Points

PII: S0016-5107(08)01994-9

doi: 10.1016/j.gie.2008.05.058

© 2008 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.