Choledochal cyst type I with dilated intrahepatic biliary radicles: a type IVA mimic
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Date
2022
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Publisher
Egyptian Liver Journal
Abstract
Background: A choledochal cyst is a relatively rare congenital anomaly of the biliary tree requiring surgery as the
definitive treatment. Amongst the five Todani variants, type I poses a diagnostic and treatment challenge owing to its
infrequent, yet clinically significant mimicry for type IVA cysts.
Case presentation: We present a case of a 4-year-old female diagnosed to have a giant type IA choledochal cyst
that mimicked a type IVA cyst on radiological imaging. The patient was treated by complete cyst excision, cholecys-
tectomy, and restoration of the biliary-enteric communication by a Roux-en-Y hepaticojejunostomy. Regression of the
dilated intrahepatic radicles that counterfeited a type IVA cyst was confirmed on follow-up imaging studies.
Conclusion: Such an encounter, although rare, can significantly alter the course of management. We recommend
extrahepatic cyst excision with biliary reconstruction as the standard treatment when preoperative and intraoperative
imaging studies fall short in differentiating the aforementioned variants.
Keywords: Choledochal cyst excision, Giant choledochal cyst, Roux-en-Y hepaticojejunostomy, Todani classification
Description
Keywords
Choledochal cyst excision, Giant choledochal cyst, Roux-en-Y hepaticojejunostomy
Citation
Hando, D.J., Kitua, D.W., Bitesigilwe, M.D., Mutajwaha, J.L., Gabolwelwe, M., Chande, H.M., Mwanga, A.H., Bokhary, Z.M. and Ngiloi, P.J., 2022. Choledochal cyst type I with dilated intrahepatic biliary radicles: a type IVA mimic. Egyptian Liver Journal, 12(1), p.29.