Choledochal cysts - type IVa

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

25 Y/O female with abdominal pain and jaundice.

Patient Data

Age: 25
Gender: Female
CT

 Multiple intrahepatic cysts and a large extrahepatic cyst ralated with biliary tree.

Case Discussion

The findings are compatible with choledochal cysts ( type IVa ).

Choledochal cysts are an uncommon anomaly of  the biliary system that are manifested by cystic dilatation of the  extrahepatic or intrahepatic biliary tree or both. 

Choledochal cysts can be classified into five types1 :

  1. type 1 cyst : is most common, accounting for 80 - 90% of cases. It is divided into 
    • type 1A - cystic dilatation of the common duct
    • type 1B - focal segmental common duct dilatation
    • type 1C - fusiform dilatation of the common bile duct.
  2. type 2 cyst : accounts for about 2% of cases and consists of a true diverticulum arising from the common duct.
  3. type 3 cyst : accounting for 1 - 5% of cases, consists  of  a  choledochocele,  and  involves  only  the intraduodenal portion of the duct.
  4. type 4 cyst : is divided into 
    • type 4A : multiple intrahepatic cysts and an extrahepatic cyst, which accounts for  19%  of  cases
    • type  4B : multiple  extrahepatic cysts, which are much less common.
  5. type 5 cyst, or Caroli’s disease, consists of single or multiple intrahepatic biliary cysts. Approximately two-thirds of patients with Caroli’s disease also have extrahepatic disease.
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Case information

rID: 20611
Case created: 30th Nov 2012
Last edited: 1st Nov 2016
Inclusion in quiz mode: Included

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