Choledochal Cyst - Presentation and Treatment in an Adult

Abstract

CONFLICT OF INTEREST: NONE DECLAREDCholedochal cyst is a congenital cystic dilation of a part of bile duct that occurs most commonly in the main part of common bile duct. Diagnosis of choledochal cyst is concluded upon disproportionate expansion of extrahepatic bile duct. Symptom trias are: abdominal pain, jaundice and abdominal mass represent clinical guideline signs of diagnosis. Furthermore, hepato-biliary diseases in adults can conceal the primary condition. In addition to this, ultrasound, CT, MRI, cholangiopancreatography (ERCP), transhepatic percutane cholangiography (PTC) guide us for a detailed examination in order to verify the diagnosis. Active endoscopic cholangiography represents an important technique that provides needed anatomic solution and details in diagnosis of choledochal cyst.

Occurrence of signet-ring cell carcinoma with cholangiocarcinoma 25 years after choledochal cyst excision

“…The most common types are I and Iva, in which there is dilatation of the extrahepatic bile duct or both the extrahepatic and intrahepatic bile ducts, respectively. [ 3 ] CCCs are rare in Western countries, with an incidence of 1: 100,000 to 1: 150,000, and account for approximately 1% of all benign biliary diseases, but they are less uncommon in Asian countries. Although CCCs can be diagnosed by ultrasound, CT, and MRCP, approximately 20% of cases remain undiagnosed.…”

Cholangiocarcinoma in choledochal cyst after cystoenterostomy: how a mistreated choledochal cyst can progress to malignancy

“…Asians and women tend to have a higher incidence than Caucasians and men, though clear reasons for these tendencies are yet to be elucidated. 2 In many cases, diagnosis is made early during childhood in 80%; however, due to the advance of imaging techniques, some diagnoses are incidentally made in adulthood. 4 Symptom triads are abdominal pain, jaundice, and an abdominal mass, but only rarely do these symptoms coexist.…”

“…A choledochal cyst is a cystic dilatation of the biliary tree and a well-known cause of biliary tract malignancies. 1 2 3 It is a relatively rare disease; incidence rates ranging from 0.32% in Asia and 1 in 13,000 to 1 in 2 million births in western countries. 3 4 Most cases are diagnosed during early childhood, but between 20% to 30% of cases are first detected in adults as choledochal cyst either causing symptoms or found incidentally during imaging for an unrelated cause.…”

Experience of surgical management of rare cases of choledochal cyst in last five years—tertiary care reflection

“…CCs can be silent for many years until being detected until imaging examinations for an unrelated condition are performed. Clinical signs differ between children and adults (13). Children were more likely than adults to have the traditional triad of jaundice, discomfort in the right hypochondrium, and a palpable lump (85 percent versus 25 percent, respectively) (2).…”