Presentation
Fusiform CBD dilatation on ultrasonography.
Patient Data
Age: 65 years
Gender: Female
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Diffuse fusiform dilatation of the CBD, reaching 15 mm in caliber, associated with:
- pancreaticobiliary maljunction type a (stenotic type)
- diffuse cystic ectasia of the cystic duct (8 mm)
- no ductal stones or masses
- normal configuration of the gall bladder with no luminal signal defects
- no intrahepatic biliary dilatation observed
- the pancreatic duct is not dilated
Case Discussion
MRCP shows dilatation of the entire extrahepatic bile duct consistent with choledochal cyst type I (Todani Ic). There is fusiform dilatation involving the main bile duct and common hepatic duct with associated with anomalous pancreaticobiliary junction type a (stenotic type) in which there is a stenotic segment of the distal common bile duct, which joins the common channel.
Choledochal cyst type I has three types:
- type Ia: cystic dilatation of entire extrahepatic biliary tree
- type Ib: focal segmental (often distal) saccular dilatation of extrahepatic bile duct
- type Ic: fusiform dilatation of extrahepatic biliary tree