Clinical Presentation

A 10-year-old girl with abdominal pain.

Further Work-up

(A) Axial computed tomography image: There is fluid around the pancreas, and the distal common bile duct (CBD) is dilated (arrow). (B) Magnetic resonance cholangiopancreatography (MRCP): There is diffuse dilatation of the extrahepatic bile duct. Note the insertion of the pancreatic duct onto the CBD proximal to the papilla (long common channel, arrow).

Differential Diagnosis

• Choledochal cyst: Marked dilatation of the CBD associated with a long common channel of the pancreatic duct and CBD is consistent with choledochal cyst.

• Stricture of the CBD: