Ultrasonographic spectrum of choledochal cysts in children

Kangarloo, Hooshang; Sarti, Dennis A.; Sample, W. Frederick; Amundson, G M

doi:10.1007/bf00973963

Cited by 32 publications

(9 citation statements)

References 6 publications

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“…boys, although a female predominance has been reported (Alonso-Lej et al, 1959;Bass & Cremin, 1976;Kangarloo et al, 1980). Only two of the six children had localized involvement of the common bile duct.…”

Section: Discussionmentioning

confidence: 89%

“…The association of cystic dilatation of the common bile duct and intrahepatic dilatation has been described but the reports in the literature suggest this to be rare and in older children (Valayer & Alagille, 1975;Todani et al, 1978). Various subtypes have been described (Todani et al, 1978;Kangarloo et al, 1980). With the increasing use of ultrasound in patients presenting with cholestasis there has been an increased frequency of cases of choledochal cyst noted with intrahepatic disease (DiPietro & Taylor, 1980;Kangarloo et al, 1980;Han et al, 1981;Mettler et al, 1981).…”

mentioning

confidence: 91%

“…Various subtypes have been described (Todani et al, 1978;Kangarloo et al, 1980). With the increasing use of ultrasound in patients presenting with cholestasis there has been an increased frequency of cases of choledochal cyst noted with intrahepatic disease (DiPietro & Taylor, 1980;Kangarloo et al, 1980;Han et al, 1981;Mettler et al, 1981).…”

mentioning

confidence: 97%

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Congenital biliary dilatation: a spectrum of disease detailed by ultrasound

Young

Blane

White

et al. 1990

The British Journal of Radiology

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Recently we have examined six children with the diagnosis of choledochal cyst who demonstrate a greater spectrum of biliary involvement than expected. Classically choledochal cysts have been divided into types and subtypes based on the configuration of common bile duct dilatation; however, this simplified information is misleading since surgical management is dependent on the exact extent of intrahepatic and extrahepatic biliary abnormalities. The pre-operative ultrasound examination must be meticulous to provide enough pertinent anatomic details. Much of the intrahepatic anatomy is not visualized at surgery nor on the operative cholangiograms where reflux of contrast into the intrahepatic ducts may not be consistently achieved.

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Section: Discussionmentioning

confidence: 89%

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confidence: 91%

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Congenital biliary dilatation: a spectrum of disease detailed by ultrasound

Young

Blane

White

et al. 1990

The British Journal of Radiology

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“…Our patient showed dilatation of both intra and extra-hepatic bile ducts and a distended gall bladder. The sonographic appearance of a choledochal cyst is reported to mimic bile-plug syndrome [5] with either a concentric or an eccentric dilatation of the common bile duct [8,9]. Echogenic structures are reported to fill the common bile duct and are also seen in the gall bladder.…”

Section: Discussionmentioning

confidence: 98%

Bile-plug syndrome

et al. 1988

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“…The complete triad has been reported as present in 19%â€"60%of cases [13â€" 1 5]. Jaundice is the most common presenting symptom in nearly 70% of the patients [9,14]. Many theories have been proposed regarding its etiology [13,15].…”

Section: Discussionmentioning

confidence: 99%

Choledochal cyst with bile duct dilatation: sonography and 99mTc IDA cholescintigraphy

Han¹,

Babcock²,

Gelfand³

1981

American Journal of Roentgenology

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Three cases of choledochal cyst associated wIth Intrahepatic biliary dilatation are presented. Findings on sonographyIncluded a large cystic mass in the porta hepatis separate from the gallbladder;a dilated common hepatlc or common bile duct entering directly Into the cyst; and smaller cystic masses of dilated central intrahepatic ducts. The dIlatation of the central lntrahepatlc bile ducts was moderate In two patients and massive in one patient. All three patients underwent operation with lntraoperative cholangiography.Two patients had se@@@Tc IDA cholescintigraphywhich confirmed the Choledochal cyst, a dilatation of the biliary ductal system, is uncommon. Although the most common form of the disease is cystic or fusiform dilatation of the common bile duct, choledochal cysts with dilated intrahepatic bile ducts recently have been recognized with increasing frequency [1 , 2]. The diagnosis of choledochal cyst has been difficult to make preoperatively because the clinical picture may vary from the almost complete absence of symptoms to the manifes tation of a classic triad of right upper quadrant pain, mass, and jaundice. Invasive techniques such as intravenous cholangiography, arteriography, endoscopic retrograde cholangiopancreatography, and percutaneous transhepatic cholan giography have been used for diagnosis [3â€"5].Recently sonography has been suggested as having an important role in evaluating this entity [6â€"12]. We present three cases of choledochal cyst associated with intrahepatic biliary dilatation where an accurate preoperative diagnosis was made by combined B-mode and real-time sonography complemented by e9mTc IDA cholescintigraphy, thereby obviating more invasive diagnostic techniques in all three cases. CaseReports Case 1A 2-year-old girl was referred to Children's Hospital Medical Center because of recurrent lowerabdominal pain and vomitingfor 7 months.Initially,her pain wasthoughtto be due to intermittent ileocolic intussusception; however, barium enema on two separate occasions did not show any evidence of intussusception. Repeated liver function tests were normal. Abdominal sonography (fig. 1A) demonstrated an abnormal cystic mass with branching tubular structures in the hilum of the liver. A distended gallbladder was noted separate from the cystic mass. Smaller cystic structures were seen in the central part of the liver representing dilated intrahepatic bile ducts. A 99â€•Tc dimethyl-IDA scan (figs. 1B and 1C) demonstrated hepatic uptake at 10 mm and delayed filling and retention in the choledochal cyst at 21 hr after injection. Isotope activity in the intestine could not be clearly identified. The preoperative diagnosis of choledochal cyst with intrahepatic duct dilatation was confirmed at operation. In addition, marked narrowing of the distal common bile duct was

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Ultrasonographic spectrum of choledochal cysts in children

Cited by 32 publications

References 6 publications

Congenital biliary dilatation: a spectrum of disease detailed by ultrasound

Congenital biliary dilatation: a spectrum of disease detailed by ultrasound

Bile-plug syndrome

Choledochal cyst with bile duct dilatation: sonography and 99mTc IDA cholescintigraphy

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