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Case Reports
. 2018 Jul-Sep;23(3):161-163.
doi: 10.4103/jiaps.JIAPS_199_17.

A Rare Case of a Common Hepatic Duct Stricture Secondary to an Anteriorly Crossing Right Hepatic Artery in an Infant

Aureen D'Cunha  1 , B S S Ravi Kishore  1 , Isaac Tharu Varghese  1
Affiliations
Case Reports

A Rare Case of a Common Hepatic Duct Stricture Secondary to an Anteriorly Crossing Right Hepatic Artery in an Infant

Aureen D'Cunha et al. J Indian Assoc Pediatr Surg. 2018 Jul-Sep.

Abstract

A 1-year-old male child presented with progressive jaundice. Investigations were suggestive of an obstructive pathology with a suspected choledochal cyst on imaging. Intraoperative cholangiogram demonstrated runoff of contrast from the cystic duct into the common bile duct with no opacification of the biliary system proximal to this. Intraoperatively, the right hepatic artery was found anteriorly crossing the common hepatic duct (CHD) causing extrinsic compression leading to complete obstruction. Following stricture excision and anastomosis of the dilated bulbous CHD to a Roux-en-Y jejunal loop, the child recovered completely. An anteriorly crossing right hepatic artery causing obstruction to the biliary duct is a rare occurrence, more so in infancy. An excision with a hepaticojejunostomy is straight forward and curative.

Keywords: Aberrant right hepatic artery; common hepatic duct stricture; obstructive jaundice.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Intraoperative cholangiogram demonstrating a) Free flow of dye into the duodenum b) Abrupt cutoff of the duct proximal to the cystic duct (arrowhead)
Figure 2
Figure 2
Perioperative image showing H: Dilated common hepatic duct, A: Anteriorly crossing right hepatic artery, C: Cystic duct lying parallel and inferior to the artery, G: Gallbladder
Figure 3
Figure 3
Cystic duct leading to the common bile duct after division from the strictured hepatic duct without drainage of bile
See this image and copyright information in PMC

References

    1. Debray D, Pariente D, Urvoas E, Hadchouel M, Bernard O. Sclerosing cholangitis in children. J Pediatr. 1994;124:49–56. - PubMed
    1. Holcomb GW, Jr, O'Neill JA, Jr, Holcomb GW., 3rd Cholecystitis, cholelithiasis and common duct stenosis in children and adolescents. Ann Surg. 1980;191:626–35. - PMC - PubMed
    1. Hancock BJ, Wiseman NE, Rusnak BW. Bile duct stricture in an infant with gastroschisis treated by percutaneous transhepatic drainage, biliary stenting, and balloon dilation. J Pediatr Surg. 1989;24:1071–3. - PubMed
    1. Ju JW, Kim MC, Kim YH, Oh JY, Nam KJ, Rho MH. Hepatocholelithiasis due to compression of common hepatic duct by right hepatic artery. Korean J Hepatobiliary Pancreat Surg. 2000;4:241–5.
    1. Honma S, Matsuda W, Kudo M. Right hepatic artery traveling anteriorly to the common bile duct. Anat Sci Int. 2013;88:93–6. - PubMed

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