A Congenital Choledochal Cyst in an Adolescent: A Unique Case Report and the Role Liver-Specific Contrast Agents in the Diagnosis of Challenging Cases

Abstract

Choledochal cysts are rare congenital cystic dilatations of the biliary tree. They are most commonly present in female infants and young children, and their pathology remains unclear. The triad of intermittent jaundice, abdominal mass, and pain is found only in a minority of patients. Diagnosis and delineation of accurate biliary anatomy are crucial for surgical planning. This is most often successfully achieved with ultrasound and magnetic resonance cholangiopancreatography. The definitive treatment is cyst excision which decreases the risk of biliary carcinoma. We present an unusual case of a choledochal cyst in an adolescent boy with a review of the literature and emphasis on multi-imaging modalities, including the role of liver-specific gadolinium contrast agents in challenging cases to confirm the diagnosis.

A Rare Case of a Giant Choledochal Cyst in a Caribbean Infant

“…Choledochal cysts, first described in 1723, are rare congenital cystic dilatations of the biliary tree [ 1 ]. They are commonly found among East Asian children and are more common in female infants [ 2 ].…”

“…Choledochal cysts are rare congenital abnormalities of the biliary tree [ 1 ]. They usually present in paediatric patients.…”

Surgical treatment of type-II choledochal cyst: a case report

“…3 Surgery is the treatment of choice to avoid the risk of complications such as pancreatitis, choledocholithiasis or cholangiocarcinoma and includes complete excision of the cyst (including the gallbladder) with biliary-enteric reconstruction. 4…”