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Case Reports
. 2020:70:33-36.
doi: 10.1016/j.ijscr.2020.03.014. Epub 2020 Apr 2.

Choledochal cyst- unusual presentation in the adult phase: Case report

Victor Vinicius Monteiro Lins de Albuquerque  1 , Frank Pinheiro De Macedo  2 , Ketlen G Costa  3 , Zuriel Rodrigues Seixas Nunes  4 , Rubem A da Silva Junior  5
Affiliations
Case Reports

Choledochal cyst- unusual presentation in the adult phase: Case report

Victor Vinicius Monteiro Lins de Albuquerque et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: Bile duct cysts are congenital malformations characterized by bile duct dilatation with intra and/or extrahepatic localization. About 80% of cases are diagnosed in childhood, so their presentation in adults is rare and repeatedly associated with complications.

Presentation of case: A 38-year-old female patient complained of severe abdominal pain for one month, with no associated cholestatic signs. She underwent abdominal ultrasonography that showed cholelithiasis with extrahepatic bile duct dilatation and underwent cholangiography (MRI), which revealed fusiform dilatation of the proximal portion of the hepatocholedochal, compatible with choledochal cyst.

Discussion: In adult patients, clinical manifestations are usually nonspecific, and the diagnosis is established by medical imaging. Magnetic resonance cholangiopancreatography (MRCP) is the gold standard diagnostic today. Treatment with better prognosis consists of total cyst resection with hepaticojejunal anastomosis and intestinal transit reconstruction with Roux-en-Y.

Conclusion: Bile duct cysts are a rare condition in adults. Currently, increasing access to more accurate medical imaging enables early diagnosis, contributing to the use of therapeutic methods in appropriate time, avoiding development of complications.

Keywords: Choledochal cyst; Hepaticojejunal anastomosis; Todani’s classification.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
MRI showing fusiform dilatation of the proximal portion of the hepatocholococcus (arrow), measuring up to 2.5 cm, compatible with Todani type I choledochal cyst.
Fig. 2
Fig. 2
Surgical specimen after resection of the main biliary tract.
See this image and copyright information in PMC

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