Choledocal cyst

Case contributed by Dr Hidayatullah Hamidi

Presentation

Abdominal pain, jaundice, and fever for one week.

Patient Data

Age: 6 years
Gender: Male

Dilatation of the intrahepatic ducts, common hepatic duct, and common bile duct (10 mm) is noted with tapering end of the common bile duct at the pancreatic head region. The distal common bile duct is not significantly dilated (5.8 mm). The pancreatic duct is also visible and not dilated (2.1 mm in diameter).

The gall bladder is distended filled with sludge.

No cholelithiasis or choledocholithiasis is seen.

No Ascaris worm is seen in the dilated ducts.

CT images confirm the sonographic findings of dilated intrahepatic ducts, common hepatic duct and common bile duct with tapering end of the common bile duct at the pancreatic head area.

Case Discussion

Keeping with the significantly dilated intrahepatic ducts and proximal parts of the common bile duct, the features are more likely of a choledochal cyst (type IVa according to Todani classification).

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