Choledochal cyst

Case contributed by Shervin Sharifkashani
Diagnosis almost certain

Presentation

Two-week abdominal pain with a history of cholecystectomy two years ago.

Patient Data

Age: 45 years
Gender: Male
ct

Largely cystic-tubular distension of common bile duct (CBD) and distension of intrahepatic bile ducts more in proximal segments. Note that the pancreatic duct is not dilated and no gross mass lesion within distal CBD is seen. The gallbladder is not seen due to the previous cholecystectomy. 

Case Discussion

Biliary tract disorder can be ignored during the cholecystectomy procedure and manifests two to three years after the procedure. Choledochal cysts are classified into 5 types. These cysts are often associated with intrahepatic bile ducts dilation and can be complicated with pancreatitis and cholangitis and the definitive treatment is surgical excision of the cysts and hepaticojejunostomy.

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