Recurrent bacterial cholangitis due to a juxtapapillary diverticulum

We present a patient with recurrent bacterial cholangitis. Endoscopic retrograde cholangiopancreatography did not show evidence for choledocholithiasis or obstructing abnormalities of the common bile duct. However, a juxtapapillary diverticulum was situated at the edge of the papilla of Vater. We postulate that a juxtapapillary diverticulum can obstruct biliary flow due to its anatomical relation with the papilla, which may predispose to bacterial cholangitis. This might be prevented by sphincterotomy of the papilla.