Congenital cystic dilatation of the common bile duct: relationship to anomalous pancreaticobiliary ductal union

Kimura, Kazuhiro; Ohto, Masao; Ono, Takamasa; Tsuchiya, Yukihiro; Saisho, Hiromitsu; Kawamura, Kazutoshi; Yogi, Yoshikuni; Karasawa, Eii; Okuda, Kunio

doi:10.2214/ajr.128.4.571

Cited by 134 publications

(71 citation statements)

References 7 publications

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“…Lilly argued that jaundice should be more commonly seen in infants and abdominal pain in older patients, probably due to the better capacity to verbalize 10 . Though abdominal pain, jaundice and abdominal mass are described as the classic triad of choledochal cyst 5 , their association was not observed in this study, in disagreement with data reported by other authors 3,7,11 . Although the concept that this presentation would be more frequent in children than in adults 7 , it is believed that early diagnosis in the current era would prevent the choledochal cyst from greatly increasing in volume, explaining the absence of an abdominal mass.…”

Section: Results Results Results Resultscontrasting

confidence: 99%

Choledochal cyst in childhood: review of 30 cases

Forny

Ferrante

Silveira

et al. 2014

Rev. Col. Bras. Cir.

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We observed a marked female predominance (73.4% of cases), the diagnosis being made in the first decade of life in 90% of patients. The most prevalent clinical manifestation was jaundice (70% of cases) and the classic triad of choledochal cyst was not observed. Abdominal ultrasound was the first imaging examination performed, with a sensitivity of 56.6%, with diagnostic definition in 17 children. Two patients (6.6%) had prenatal diagnosis. All patients underwent surgical treatment, cyst resection with Roux-en-Y hepaticojejunostomy being performed in 80% of cases. The incidence of postoperative complications was 13.3% and the mortality rate was 6.6%, ie two patients were diagnosed with Caroli's disease. ConclusionConclusion Conclusion Conclusion Conclusion: The non-observance of the classic triad of choledochal cyst suggests that its incidence is lower than that reported in the medical literature. The surgical treatment of choledochal cysts, with resection and bilioenteric anastomosis, is safe even for small children.

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Section: Results Results Results Resultscontrasting

confidence: 99%

Choledochal cyst in childhood: review of 30 cases

Forny

Ferrante

Silveira

et al. 2014

Rev. Col. Bras. Cir.

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“…Although the etiology is not known, it has been shown that in at least 94% of choledochal cysts there are anomalous insertions of the common bile duct into the pancreatic duct. 2 It is believed that this allows reflux of pancreatic enzymes into the biliary tree leading to ductal dilatation and scarring. Among the various classification schemes, that of Todani is widely used.…”

Section: Denouement and Discussionmentioning

confidence: 99%

Neonatal type 1 choledochal cyst

Herman

Siegel

2007

J Perinatol

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“…Many theories have been proposed regarding its etiology [13,15]. The most acceptable new theory of the etiology of choledochal cyst is based on an anomalous relation between the common bile duct and the pancreatic duct, allowing reflux of pan creatic juice into the biliary ductal system which results in cholangitis and dilatation of the biliary duct [5,16,17] Bt@causeof associated severe stenosis of the common bile duct distal to the choledochal cyst in our patients, the relation between the common bile duct and the pancreatic duct was not clearly demonstrated, and the anomalous relation between the common bile duct and the pancreatic duct was not confirmed. All three of our cases had cystic dilatation of the intrahe patic bile ducts and the extrahepatic bile duct and are type A'.…”

Section: Discussionmentioning

confidence: 99%

Choledochal cyst with bile duct dilatation: sonography and 99mTc IDA cholescintigraphy

Han¹,

Babcock²,

Gelfand³

1981

American Journal of Roentgenology

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Three cases of choledochal cyst associated wIth Intrahepatic biliary dilatation are presented. Findings on sonographyIncluded a large cystic mass in the porta hepatis separate from the gallbladder;a dilated common hepatlc or common bile duct entering directly Into the cyst; and smaller cystic masses of dilated central intrahepatic ducts. The dIlatation of the central lntrahepatlc bile ducts was moderate In two patients and massive in one patient. All three patients underwent operation with lntraoperative cholangiography.Two patients had se@@@Tc IDA cholescintigraphywhich confirmed the Choledochal cyst, a dilatation of the biliary ductal system, is uncommon. Although the most common form of the disease is cystic or fusiform dilatation of the common bile duct, choledochal cysts with dilated intrahepatic bile ducts recently have been recognized with increasing frequency [1 , 2]. The diagnosis of choledochal cyst has been difficult to make preoperatively because the clinical picture may vary from the almost complete absence of symptoms to the manifes tation of a classic triad of right upper quadrant pain, mass, and jaundice. Invasive techniques such as intravenous cholangiography, arteriography, endoscopic retrograde cholangiopancreatography, and percutaneous transhepatic cholan giography have been used for diagnosis [3â€"5].Recently sonography has been suggested as having an important role in evaluating this entity [6â€"12]. We present three cases of choledochal cyst associated with intrahepatic biliary dilatation where an accurate preoperative diagnosis was made by combined B-mode and real-time sonography complemented by e9mTc IDA cholescintigraphy, thereby obviating more invasive diagnostic techniques in all three cases. CaseReports Case 1A 2-year-old girl was referred to Children's Hospital Medical Center because of recurrent lowerabdominal pain and vomitingfor 7 months.Initially,her pain wasthoughtto be due to intermittent ileocolic intussusception; however, barium enema on two separate occasions did not show any evidence of intussusception. Repeated liver function tests were normal. Abdominal sonography (fig. 1A) demonstrated an abnormal cystic mass with branching tubular structures in the hilum of the liver. A distended gallbladder was noted separate from the cystic mass. Smaller cystic structures were seen in the central part of the liver representing dilated intrahepatic bile ducts. A 99â€•Tc dimethyl-IDA scan (figs. 1B and 1C) demonstrated hepatic uptake at 10 mm and delayed filling and retention in the choledochal cyst at 21 hr after injection. Isotope activity in the intestine could not be clearly identified. The preoperative diagnosis of choledochal cyst with intrahepatic duct dilatation was confirmed at operation. In addition, marked narrowing of the distal common bile duct was

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Congenital cystic dilatation of the common bile duct: relationship to anomalous pancreaticobiliary ductal union

Cited by 134 publications

References 7 publications

Choledochal cyst in childhood: review of 30 cases

Choledochal cyst in childhood: review of 30 cases

Neonatal type 1 choledochal cyst

Choledochal cyst with bile duct dilatation: sonography and 99mTc IDA cholescintigraphy

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