A giant choledochal cyst: A case reported from Tanzania

Abstract

Highlights Choledochal cyst is a rare malformation of the common bile duct causing jaundice in the pediatric group. Diagnosis can easily be made using abdominal ultrasonography, hence a high degree of suspicion is needed among clinicians. Surgery, open or laparoscopic, remains the core management depending upon the availability of the resources and expertise.

Imaging diagnosis of a giant choledochal cyst in an infant

“…Choledochal cysts comprise a spectrum of congenital morphological abnormalities of the biliary ductal system, presenting as cystic dilatation of various segments in different combinations [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] . The reported incidence of these anomalies is relatively higher in the Asian population at the rate of 1/1000 births and much rarer in the western population in the rate of 1/100000-1/150000.…”

“…The earliest reports of this entity are attributed to Vader and Ezlerin 1723 [10] . However, Alonso-Lez and colleagues are credited with first ever classification of the entity in 1959 [5] .…”

“…However, Alonso-Lez and colleagues are credited with first ever classification of the entity in 1959 [5] . The currently followed classification is attributed to Todani et al, which dates back to 1977 [10] . The etiology of the entity has been proposed by Investigators as occurring due to reflux of pancreatic fluid in to the biliary tree, due to an anomalous pancreatico-biliary duct union.…”

“…The etiology of the entity has been proposed by Investigators as occurring due to reflux of pancreatic fluid in to the biliary tree, due to an anomalous pancreatico-biliary duct union. It is believed that the pancreatic enzymes cause injury and inflammation to the (common bile) duct walls, leading to their dilatation and cyst formation [5 , 10] . This particular theory of pancreatic fluid reflux is majorly attributed to Babbit, who had proposed the same vide his publication of 1959 [10] .…”

“…Amongst the hepatobiliary etiology of cystic abdominal masses in children, hepatic mesenchymal hamartoma, hepato-biliary cystadenoma and choledochal cysts have been reported, but are all rare [1 , 2] . A choledochal cyst is in itself a rare congenital malformation of the biliary tract and gigantic varieties of these are further rare [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] . The more frequently reported gigantic abdominal cysts in children have been found to be due to mesenteric cyst, ovarian cyst in females, enteric duplication cyst and cystic lymphangioma both of intra and retroperitoneal location [1 , 2] .…”