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Joseph Junewick, MD FACR
over 8 years ago
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Choledochal Cyst

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

Newborn with right upper quadrant cyst on prenatal US.


Case Images


Diagnosis

Choledochal Cyst, Type 1

Findings

US – Ectasia of the right and left hepatic ducts with fusiform dilation of the extrahepatic duct to the level of the pancreatic head

Discussion

Fusiform or saccular dilation of the bile duct results in choledochal cyst. Etiology of type I choledochal cyst is uncertain but may be related to distal bile duct obstruction, abnormal insertion of the common bile duct, or reflux of pancreatic enzymes into the biliary tree.

In neonates, choledochal cysts present with jaundice similar to neonatal hepatitis and biliary atresia. In older children, abdominal pain, fever and obstructive jaundice may be seen. Ultrasound is usually sufficient for diagnosis and is helpful in evaluating the ductal anatomy and presence of gallstones. MRCP is a noninvasive means to evaluate ductal anatomy if ultrasound is unsuccessful.

The most common complication of choledochal cysts is ascending cholangitis but portal hypertension, cirrhosis, maliginancy and rupture have been documented.

Reference

Gubernick JA, Rosenberg HK, Ilaslan H, Kessler A. US approach to jaundice in infants and children. Radiographics (2000); 20: 173-195.



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