Case Report
Choledochal cyst- unusual presentation in the adult phase: Case report

https://doi.org/10.1016/j.ijscr.2020.03.014Get rights and content
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Highlights

  • Bile duct cysts are a rare condition in adults.

  • The classic triad of signs and symptoms is rarely present.

  • The main treatment is surgical resection of the cyst(s).

Abstract

Introduction

Bile duct cysts are congenital malformations characterized by bile duct dilatation with intra and/or extrahepatic localization. About 80% of cases are diagnosed in childhood, so their presentation in adults is rare and repeatedly associated with complications.

Presentation of case

A 38-year-old female patient complained of severe abdominal pain for one month, with no associated cholestatic signs. She underwent abdominal ultrasonography that showed cholelithiasis with extrahepatic bile duct dilatation and underwent cholangiography (MRI), which revealed fusiform dilatation of the proximal portion of the hepatocholedochal, compatible with choledochal cyst.

Discussion

In adult patients, clinical manifestations are usually nonspecific, and the diagnosis is established by medical imaging. Magnetic resonance cholangiopancreatography (MRCP) is the gold standard diagnostic today. Treatment with better prognosis consists of total cyst resection with hepaticojejunal anastomosis and intestinal transit reconstruction with Roux-en-Y.

Conclusion

Bile duct cysts are a rare condition in adults. Currently, increasing access to more accurate medical imaging enables early diagnosis, contributing to the use of therapeutic methods in appropriate time, avoiding development of complications.

Keywords

Choledochal cyst
Todani’s classification
Hepaticojejunal anastomosis

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