Choledochal cyst and biliary atresia in the neonate: imaging findings in five cases.

Torrisi, J M; Haller, Jack O.; Velcek, Francisca T.

doi:10.2214/ajr.155.6.2122679

Cited by 33 publications

(26 citation statements)

References 7 publications

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“…8,21 It has also been suggested that, in infancy, choledochal cyst and BA are part of the spectrum of infantile obstructive cholangiopathy and may be found concurrently in this stage of life. 22 A survey of the American Academy of Pediatric Surgery Section found that 13% of patients with cystic dilatation of the CBD had extrahepatic atresia. 23 In this study, 19 of 43 (44%) cases of infantile biliary tract dilatation had an association with BA.…”

Section: Discussionmentioning

confidence: 99%

“…In the same period, we had 187 cases of BA cases, 10.6% with BDBA (19 of 187). BDBA has been reported in the literature under different medical terms, such as choledochal cyst associated with BA, 22 choledochal cyst associated with extrahepatic biliary BA (CCBA), 24 and type I cyst of BA. 25 In the literature, the most common type of BDBA reported is type I cyst, which has been described as a correctable type of BA in the past.…”

Section: Discussionmentioning

confidence: 99%

“…25 In the literature, the most common type of BDBA reported is type I cyst, which has been described as a correctable type of BA in the past. [22][23][24][25][26] However, some other types of BDBA have been reported. Bancroft and coworkers reported four type I cysts and one choledochal cyst contiguous with the cystic duct.…”

Section: Discussionmentioning

confidence: 99%

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Dilatation of the biliary tree in children: sonographic diagnosis and its clinical significance.

Lee

Yeung

Chang

et al. 2000

Journal of Ultrasound in Medicine

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We evaluated sonographically 162 children who met the criteria for biliary tract dilatation in the past 18 years. Of these, 131 patients were diagnosed as having anomalous dilatations of the biliary tree (including 112 with choledochal cysts and 19 with biliary duct dilatation and biliary atresia). Biliary tract dilatations in the other 31 patients were due to secondary causes or normal variants. All cases of intrahepatic biliary tree dilatation and those with both intra‐ and extrabiliary duct dilatations were anomalous. In 117 cases of extrahepatic biliary tract dilatation only, the mean diameter was widest in cases of choledochal cyst (21.4 +/‐ 12.1 mm, compared with cases of biliary tract dilatation with biliary atresia (10 +/‐ 2.4 mm), secondary biliary duct dilatation (8.5 +/‐ 1.5 mm), and normal variants (4.4 +/‐ 1.2 mm) (P < 0.001). Of the 43 infants with biliary tree dilatation, 24 (56%) had choledochal cysts and 19 (44%) had biliary tract dilatation associated with biliary atresia. Excluding cases associated with biliary atresia, the accuracy of diagnosing choledochal cysts in extrahepatic biliary tract dilatation was 71% and 97% using cutoffs of 7 mm and 10 mm as the minimum diameter, respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Dilatation of the biliary tree in children: sonographic diagnosis and its clinical significance.

Lee

Yeung

Chang

et al. 2000

Journal of Ultrasound in Medicine

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“…In patients with choledochal cysts, hepatobiliary scintigraphy shows a photopenic defect over the porta hepatis on early images, with delayed accumulation of tracer in the photopenic area indicating communication with the biliary system [20]. Nonvisualization of radionuclide activity in the bowel is consistent with distal biliary atresia.…”

Section: Discussionmentioning

confidence: 94%

Choledochal cysts: Ultrasonographic findings and correlation with other imaging modalities

et al. 1994

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In the past, choledochal cysts had been infrequently diagnosed prior to surgical exploration for obstructive jaundice. However, with the advance of imaging modalities, preoperative diagnosis is usually apparent. We evaluated the radiological findings of choledochal cysts in 14 patients in whom ultrasonography (US) or computed tomography (CT) were mainly used for diagnosis. In addition, oral cholecystography, intravenous (i.v.) cholangiography, scintigraphy, and percutaneous transhepatic cholangiography were performed in some of them. The diagnosis was confirmed surgically in all patients. Ultrasonographic examinations were diagnostic in 13 of 14 patients. Preoperative specific diagnosis of choledochal cyst was possible with the demonstration of direct entrance of the extrahepatic bile ducts into the cyst in most cases. When US fails to show relation of cystic mass with biliary system, other imaging modalities can be used to clarify the findings.

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“…The differentiation between the infantile CDC and BA with cystic dilatation has been the subject of debate and the issue has been confounded further by usage of terms like ''choledochal cyst with biliary atresia'' in the literature [1,11]. There is a considerable overlap between the infantile CDC and BA with cystic dilatation in terms of clinical profile, associated total obliteration of the distal bile duct and early onset liver fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Experience with choledochal cysts in infants

et al. 2006

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The purpose of this analysis is to study the clinical features, liver histology and the outcome after surgery in infants with choledochal cysts (CDCs), and to draw conclusions on the management strategy accordingly. The clinical features, liver histology and the outcome after surgery in 14 cases of CDCs treated before 1 year of age (the "infantile group") were compared with 52 cases that were diagnosed and treated between 1 and 12 years of age (the "classical pediatric group"). The differentiation of the "infantile choledochal cysts" from "biliary atresia with cystic dilatation" was based on the configuration of intrahepatic bile ducts on cholangiogram. Jaundice was the universal presenting feature in 14 patients in the "infantile group", the clinical presentation in 6 infants was indistinguishable from biliary atresia. On the other hand, pancreatitis as a presenting complication was seen exclusively in those presenting later, i.e. the "classical pediatric group". Fibrosis, as early as 4 weeks of age, was seen in all nine (100%) infants in whom a liver histology was available. Seven of these nine infants had bridging fibrosis (n = 4) or cirrhosis (n = 3) on liver histology. The outcome was satisfactory in 9 of the 14 (64.3%) infants despite bridging fibrosis (n = 4) or cirrhosis (n = 1) in 5 of these 9 babies. The CDCs presenting in infancy differ from the classical variety of later presenting pediatric CDCs in terms of their presentation, liver histology and outcome. They merit an emergent surgical treatment following which the outcome is satisfactory. Delay results in progression to end stage liver disease.

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Choledochal cyst and biliary atresia in the neonate: imaging findings in five cases.

Cited by 33 publications

References 7 publications

Dilatation of the biliary tree in children: sonographic diagnosis and its clinical significance.

Dilatation of the biliary tree in children: sonographic diagnosis and its clinical significance.

Choledochal cysts: Ultrasonographic findings and correlation with other imaging modalities

Experience with choledochal cysts in infants

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