Diagnosis and treatment of choledochocele complicated by choledocholithiasis (case report)

Abstract

We report a case of choledochocele associated with choledocholithiasis. The patient became symptomatic when a gallstone was trapped within the choledochocele, causing intermittent biliary obstruction. Endoscopic retrograde cholangiography (ERC) provided the diagnosis and endoscopic sphincterotomy was performed for definite nonoperative treatment. The lesion could not be identified on ultrasound even after its demonstration by ERC. The importance of direct cholangiography in the diagnosis of a choledochocele is discussed.

Choledochocele demonstrated on conventional sonography

“…Although conventional transabdominal sonography can certainly be used as an initial diagnostic modality, unambiguous demonstration of choledochocele is difficult compared with other types of choledochal cyst. 9,11,[14][15][16] In fact, no previous reports have provided unambiguous sonographic images of choledochocele. Moreover, choledochocele tends to be overlooked on sonography because of its anatomical localization, particularly when the lesion is small.…”