TYPE B CHOLEDOCHOCELE: A RARE PRESENTATION WITH A COMMON TREATMENT
Review of Literature and a case report
DOI: 10.54647/cm32918 60 Downloads 3526 Views
Author(s)
Abstract
Introduction: Biliary dilation is a rare disease involving intrahepatic and extrahepatic biliary tract abnormalities. Choledochocele or type III choledochal cyst (CC) is a lesion present in less than 2% of all reported cases and is defined as a cystic dilation of the distal common bile duct protruding into the duodenal lumen.
Objective: To report on the endoscopic treatment of type III common bile duct cyst, as well as a review of the literature on the subject.
Case presentation: A 61-year-old female patient complained of severe abdominal pain for one month, with no associated cholestatic signs. She underwent abdominal ultrasonography that showed cholelithiasis. First diagnostic suspicion was cholecystitis, so she underwent emergency open cholecystectomy. The patient presented a torpid post-surgical evolution with jaundice, where control ultrasound showed extrahepatic bile duct dilation. MRI cholangiography revealed a fusiform dilation of the proximal portion of the hepatocholedochal, compatible with a choledochal cyst.
Conclusion: Our case presented with relatively rare manifestations and involved one of the undiscussed categories of the Todani classification system; thus, highly relevant. Endoscopic sphincterotomy is a feasible and effective treatment for choledochocele including large and protruding ones.
Keywords
biliary dilatation, choledochocele, CC, MRI, sphincterotomy
Cite this paper
Erick Servin Torres, Silvana Castelán-Sánchez, Eulalio Jiménez-González,
TYPE B CHOLEDOCHOCELE: A RARE PRESENTATION WITH A COMMON TREATMENT
Review of Literature and a case report
, SCIREA Journal of Clinical Medicine.
Volume 7, Issue 6, December 2022 | PP. 351-360.
10.54647/cm32918
References
[ 1 ] | Todani T, Watanabe Y, Narusue M et al. Congenital bile duct cysts: classification, operative procedures, and review of thirtyseven cases including cancer arising from choledochal cyst. Am J Surg 1977; 134: 263–269 |
[ 2 ] | F. Alonzo-Lej, W.B. Revor Jr, D.J. Pessagno, Congenital choledochal cyst, with a report of 2, and an analysis of 94 cases, Surg. Gynecol. Obstet. Int. Abstr. Surg. 108 (1) (1959) 1–30. |
[ 3 ] | Law R, Topazian M. Diagnosis and treatment of choledochoceles. Clin Gastroenterol Hepatol 2014; 12: 196–203 |
[ 4 ] | Ohtsuka T, Inoue K, Ohuchida J et al. Carcinoma arising in choledochocele. Endoscopy 2001; 33: 614–619 |
[ 5 ] | Kagiyama S, Okazaki K, Yamamoto Y. Anatomic variants of choledochocele and manometric measurements of pressure in the cele and the orifice zone. Am J Gastroenterol 1987; 82:641–649. |
[ 6 ] | Law R, Topazian M. Diagnosis and treatment of choledochoceles. Clin Gastroenterol Hepatol. 2014;12(2):196–203 |
[ 7 ] | Wheeler W. An unusual case of obstruction to the common bile duct (choledochocele?). Br J Surg 1940;27:446–448. |