Choledochal cyst with chronic calcific pancreatitis

Case contributed by Dr Praveen Jha

Presentation

Non-specific abdominal pain. Indigestion. No prior imaging done.

Patient Data

Age: 35
Gender: Female

Multiple coarse calcifications in head of pancreas with dilated pancreatic duct. Fusiform dilatation of common bile duct is seen with smooth tapering at distal end. Intrahepatic biliary radicals are also dilated. No radio-opaque intraluminal calculi in biliary tract.

Markedly dilated common bile duct, common hepatic duct, right hepatic duct and left hepatic ducts. No obstructive calculi or any obvious mass. Mildly prominent pancreatic duct.

Case Discussion

Choledochal cyst, when associated with anomalous pancreatobiliary drainage, may cause pancreatitis. As seen in this case, chronic calcific pancreatitis involving uncinate process is seen.

As this case shows fusiform dilatation of common bile duct, it may be classified as Type I choledochal cyst, in spite of intrahepatic biliary dilatation, which may be due to anomalous pancreaticobiliary drainage.

However, differentials like distal stricture of common bile duct or any occult ampullary mass exist. Patient could not be followed up, and final comment regarding biliary anomaly remains unclear.

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Case Information

rID: 18245
Case created: 22nd Jun 2012
Last edited: 24th Jan 2016
Inclusion in quiz mode: Included

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