A 49-year-old man presents with acute abdominal pain and jaundice. Radiographic studies reveal a tumor in the head of the pancreas. Which of the following structures is most likely being obstructed?
The common bile duct is located at the head of the pancreas and receives contents from the cystic duct and hepatic duct. An obstruction at this site causes a backup of bile back through the common bile duct and hepatic duct, with resulting pain and jaundice. The common hepatic duct is located more superior to the head of the pancreas and leads into the cystic duct. The cystic duct allows bile to enter the gallbladder from the common bile duct (draining the liver) and releases bile to the common bile duct. The accessory pancreatic duct is not affected by an obstruction of the common bile duct due to a lack of any connections between the two ducts. The proper hepatic artery will not be obstructed, for it carries blood from the liver to the inferior vena cava.
Common bile duct
Common hepatic duct
Cystic duct
Accessory pancreatic duct
Abdomen & Pelvis