Fetal choledochal cysts are choledochal cysts diagnosed in utero.
The estimated incidence rate of choledochal cysts is ~1 in 2 million live births 2. There is a recognsed female predilection and a greater occurrence in Asian populations.
It may be seen as an anechoic fetal intra-abdominal cyst within or close to the fetal liver.
Demonstration of continuity with the fetal gall bladder or hepatic ducts or presence of associated intra- and extrahepatic ducts may further further aid the diagnosis.
Treatment and prognosis
Surgical excision with a Roux-en-Y hepaticojejunostomy anastomosis is often performed post partum as part of management.
On ultrasound, the main differential considerations for the cyst within the adjacent to the liver include
- 1. Frank JL, Hill MC, Chirathivat S et-al. Antenatal observation of a choledochal cyst by sonography. AJR Am J Roentgenol. 1981;137 (1): 166-8. AJR Am J Roentgenol (citation) - Pubmed citation
- 2. Lee IH, Kim GJ. Fetal choledochal cyst diagnosed at 22 weeks of gestation by three-dimensional ultrasonography: a case report. J. Korean Med. Sci. 2008;23 (5): 909-11. doi:10.3346/jkms.2008.23.5.909 - Free text at pubmed - Pubmed citation
- 3. Dewbury KC, Aluwihare AP, Birch SJ et-al. Prenatal ultrasound demonstration of a choledochal cyst. Br J Radiol. 1980;53 (633): 906-7. doi:10.1259/0007-1285-53-633-906 - Pubmed citation
- 4. Elrad H, Mayden KL, Ahart S et-al. Prenatal ultrasound diagnosis of choledochal cyst. J Ultrasound Med. 1985;4 (10): 553-5. J Ultrasound Med (citation) - Pubmed citation
- 5. Nasu K, Matsuki S, Kawano Y et-al. Choledochal cyst diagnosed and conservatively treated during pregnancy. Am J Perinatol. 2004;21 (8): 463-8. doi:10.1055/s-2004-835963 - Pubmed citation
- 6. Nassar AH, Chakhtoura N, Martin D et-al. Choledochal cysts diagnosed in pregnancy: a case report and review of treatment options. J Matern Fetal Med. 2001;10 (5): 363-5. J Matern Fetal Med (link) - Pubmed citation
- 7. Schroeder D, Smith L, Prain HC. Antenatal diagnosis of choledochal cyst at 15 weeks' gestation: etiologic implications and management. J. Pediatr. Surg. 1989;24 (9): 936-8. J. Pediatr. Surg. (link) - Pubmed citation
- 8. Wiedman MA, Tan A, Martinez CJ. Fetal sonography and neonatal scintigraphy of a choledochal cyst. J. Nucl. Med. 1985;26 (8): 893-6. J. Nucl. Med. (link) - Pubmed citation
- 9. Frank JL, Hill MC, Chirathivat S et-al. Antenatal observation of a choledochal cyst by sonography. AJR Am J Roentgenol. 1981;137 (1): 166-8. AJR Am J Roentgenol (citation) - Pubmed citation
- 10. Wu DQ, Zheng LX, Wang QS et-al. Choledochal cysts in pregnancy: case management and literature review. World J. Gastroenterol. 2004;10 (20): 3065-9. World J. Gastroenterol. (link) - Pubmed citation