2013, Number 6
Type I choledocal cyst: imaging diagnosis and hepaticoduodenostomy as a therapeutic measure
Tello de Meneses SA, Riggen ML, Orozco CEG
Full text
Language: Spanish
References: 9
Page: 482-487
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ABSTRACT
Background. Choledochal cyst is a congenital cystic dilatation of the intra- or extrahepatic biliary tree. It may affect only the extrahepatic bile duct (type I, II and III), intrahepatic (type V) or both (type IVa). Diagnosis is primarily made with imaging, abdominal ultrasound being the first modality used. However, in case of a diagnostic doubt using this means, a technectium-99 HIDA scan, which has a sensitivity of 100% for type I cysts (sacciform), may be performed. It may be useful for distinguishing between choledochal cyst and biliary atresia. Computed tomography scan with contrast can also be used.Case report. We present the case of a 2-year-old female who was admitted to the Emergency Department because of abdominal pain. She underwent abdominal USG, which reported acute cholecystitis and a cystic image adjacent to the cystic duct fibrosis consistent with a choledochal cyst.
Conclusions. The elective treatment for type I choledochal cyst is resection of the cyst with Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy. The latter is considered a useful and reliable alternative in our context, although initially it fell into disuse due to reports of ascending cholangitis. However, this has not been recently documented.
REFERENCES
Gallardo-Meza AF, González-Sánchez JM, Villarroel-Cruz R, Piña-Garay MA, Medina-Andrade MA, Martínez-de la Barquera A, et al. Hepático-duodeno-anastomosis, ¿técnica de elección para el tratamiento de quiste de colédoco? Seguimiento a largo plazo. Un estudio interinstitucional. Rev Mex Cir Pediatr 2009;16:80-83.