TITLE:
Choledochal cyst: A difficult diagnosis
AUTHORS:
Abdelmounaim Ait Ali, Fedoua Rouibaa, M. Bekkar, Hicham Baba, Ibrahima Sall, Ahmed Bounaim, Aziz Zentar, A. Aourarh, Khalid Sair
KEYWORDS:
Choledochal Cyst; Jaundice; Echoendoscopy; Biliary MRI
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.3 No.1,
February
28,
2013
ABSTRACT:
Choledochal cyst is defined as
a cystic dilatation of the distal common bile
duct protruding into the duo- denum. It is considered as the rarest congenital
cyst of the biliary tract by 1.4%. We report a 46 years old woman who presented
with recurrent jaundice associated with abdominal pain of 07 years duration. The
liver function tests showed cholestasis. The abdominal scan and Biliary MRI revealed
a dilatation of intrahepatic, pancreatic ducts and a dilatation of the common
bile duct with a stenosis in its the lower part. The diagnosis of a common bile
duct cholangiocarinoma was mentioned. The gastroscopy
revealed a stenosed duodenal bulb not allowing us to perform an echo endoscopy and ERCP. An intraoperative cholangiography illustrating a cystic dilatation of the
papillary region in which exist a separate protrusion of the choledochal and wirsung
ducts. Therefore, we didn’t accomplish the cephalic duodeno-pancreatectomy and we decided to realize a partial resection of the papilla.
The histolological examination proved the absence of any tumoral lesion and the
presence of biliary mucosa layered the internal surface of the cyst. The patient
is still asymptomatic after one year of the surgery.