Choledochal cyst - type Ic (MRCP)

Case contributed by Dr Mostafa El-Feky

Presentation

Fusiform CBD dilatation on ultrasonography.

Patient Data

Age: 65 years
Gender: Female

MRCP

mri

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

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