Type IV choledochal cyst presenting with obstructive jaundice: role of MR cholangiopancreatography in preoperative evaluation.

Arshanskiy, Yevgeniy; Vyas, Pranav K.

doi:10.2214/ajr.171.2.9694475

Cited by 14 publications

(5 citation statements)

References 5 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, lower cost and morbidity compared to other imaging/diagnostic modalities, and reliability for detecting abnormalities associated with CCs such as cholangiocarcinoma and choledocholithiasis, are some of the favorable features of MRCP [89,92]. Unfortunately, as seen often in patients with CCs, intraductal air, debris, stones, or protein plugs can interfere with the signal and alter visualization (Figure 4) [93].…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Pediatric Choledochal Cysts: Unknowns are Decreasing

Gezer¹

2019

Pediatric Surgery, Flowcharts and Clinical Algorithms

View full text Add to dashboard Cite

Choledochal cysts (CCs) are congenital cystic dilatation of extrahepatic and/ or intrahepatic bile ducts. CCs are more common in Asian population, the cause is still unknown. Although the etiology is controversial, the main elements in the natural historical emergence of the type I and type IV, which make up the majority of all types, have become clearer. The majority of CCs are diagnosed in childhood. Clinical presentation varies from jaundice in young patients to nonspecific abdominal pain in older, but morbidity increases with complications such as cholangitis, pancreatitis, perforation, hepatitis, liver failure, and malignancy in delayed diagnosed patients. MRCP is considered the current gold standard diagnostic modality that is able to accurately assess biliary anatomy. Although the treatment approach has been formed over the years, it still has not reached the last state. Eventually, the removal of the entire cyst and the reconstruction of the remaining biliary tract to drainage is the current treatment approach. But the dilemma is the way of reconstruction procedure (hepaticoduodenostomy or hepaticojejunostomy). All patients should be followed up for a long period of time, regardless of the surgery method.

show abstract

Section: Diagnostic Evaluationmentioning

confidence: 99%

Pediatric Choledochal Cysts: Unknowns are Decreasing

Gezer¹

2019

Pediatric Surgery, Flowcharts and Clinical Algorithms

View full text Add to dashboard Cite

show abstract

“…El examen inicial para la valoración de la vía biliar debe ser una ecografía, la cual sugiere el diagnóstico de quistes del colédoco en la mayoría de los pacientes; no obstante, la resonancia magnética (RM) con contraste es el estudio de elección para valorar estas estructuras 37 . Es importante tener en cuenta que algunos casos son difíciles de diagnosticar, incluso contando con la tecnología para ello, 38 ya que el aire, la sangre, los cálculos o los tapones de proteínas intraductales, comunes en pacientes con quistes del colédoco, pueden interferir con la señal y alterar la visualización 39 . Sin embargo, la sensibilidad de la colangiorresonancia magnética para el diagnóstico es cercana al 100 % 6 .…”

Section: Diagnósticounclassified

“…Algunos autores sugieren que la baja sensibilidad de la RM en la visualización de la salida pancreático-biliar se relaciona con el pequeño calibre de esta unión y sugieren la administración de secretina antes de obtener las imágenes, lo que aumenta la secreción pancreática y dilata los conductos para su mejor visualización 40 . Las ventajas de la RM sobre la colangiopancreatografía retrógrada endoscópica son que no se usa radiación ionizante, no es invasiva, no depende del operador y no produce complicaciones como colangitis o pancreatitis 37 .. La segunda permite la intervención terapéutica, pero esta solo es necesaria en los quistes del colédoco de tipo III 39 .…”

Section: Diagnósticounclassified

Quistes del colédoco

et al. 2015

View full text Add to dashboard Cite

Los quistes del colédoco son una condición médica poco frecuente, la cual se caracteriza por presentar dilatación de la vía biliar intrahepática y extrahepática; se postulan en su etiología la anomalía de la unión pancreáticobiliar, lo que favorece el reflujo del jugo pancreático al árbol biliar, y la aganglionosis del árbol biliar. Tiene una amplia gama de presentación de síntomas, y entre los principales se encuentran el dolor abdominal, la ictericia y una masa abdominal palpable. Son lesiones premalignas y, por ende, el tratamiento de elección es la resección quirúrgica completa con seguimiento a largo plazo.

show abstract

“…There is more experience with the use of MRCP in the assessment of choledochal cysts. 59–64 While MRCP can accurately assess the proximal extent of these cysts, the identification of the site of the pancreaticobiliary junction is less reliable, particularly in children. 61,62,64 …”

Section: Assessment Of Biliary Anatomymentioning

confidence: 99%

Magnetic resonance imaging and diseases of the liver and biliary tract. Part 2. Magnetic resonance cholangiography and angiography and conclusions

Macdonald

Peduto

2000

J of Gastro and Hepatol

View full text Add to dashboard Cite

Magnetic resonance cholangiography (MRC) relies on the strong T2 signal from stationary liquids, in this case bile, to generate images. No contrast agents are required, and the failure rate and risk of serious complications is lower than with endoscopic retrograde cholangiopancreatography (ERCP). Data from MRC can be summated to produce an image much like the cholangiogram obtained by using ERCP. In addition, MRC and conventional MRI can provide information about the biliary and other anatomy above and below a biliary obstruction. This provides information for therapeutic intervention that is probably most useful for hilar and intrahepatic biliary obstruction. Magnetic resonance cholangiography appears to be similar to ERCP with respect to sensitivity and specificity in detecting lesions causing biliary obstruction, and in the diagnosis of choledocholithiasis. It is also suited to the assessment of biliary anatomy (including the assessment of surgical bile‐duct injuries) and intrahepatic biliary pathology. However, ERCP can be therapeutic as well as diagnostic, and MRC should be limited to situations where intervention is unlikely, where intrahepatic or hilar pathology is suspected, to delineate the biliary anatomy prior to other interventions, or after failed or inadequate ERCP. Magnetic resonance angiography (MRA) relies on the properties of flowing liquids to generate images. It is particularly suited to assessment of the hepatic vasculature and appears as good as conventional angiography. It has been shown to be useful in delineating vascular anatomy prior to liver transplantation or insertion of a transjugular intrahepatic portasystemic shunt. Magnetic resonance angiography may also be useful in predicting subsequent variceal haemorrhage in patients with oesophageal varices.

show abstract

Type IV choledochal cyst presenting with obstructive jaundice: role of MR cholangiopancreatography in preoperative evaluation.

Cited by 14 publications

References 5 publications

Pediatric Choledochal Cysts: Unknowns are Decreasing

Pediatric Choledochal Cysts: Unknowns are Decreasing

Quistes del colédoco

Magnetic resonance imaging and diseases of the liver and biliary tract. Part 2. Magnetic resonance cholangiography and angiography and conclusions

Contact Info

Product

Resources

About