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[Choledochal cysts in adults].

E Trondsen1, T Buanes

  • 1Gastrokirurgisk avdeling, Ullevål sykehus, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|June 25, 1999
PubMed
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Choledochal cysts are rare in adults and often missed, presenting with pain, jaundice, and increased risk of malignancy. Surgical excision offers good long-term outcomes for these bile duct anomalies.

Area of Science:

  • Gastroenterology and Hepatobiliary Surgery

Background:

  • Choledochal cysts are congenital dilations of the bile ducts, rare in adults and frequently overlooked.
  • Etiology remains largely unknown, contributing to diagnostic challenges in adult populations.

Observation:

  • Adult patients present with symptoms including abdominal pain, jaundice, cholangitis, and pancreatitis.
  • Commonly associated findings include elevated liver function tests and gallstone disease.
  • A significant increased risk of malignant transformation within the cysts and adjacent organs is noted.

Findings:

  • Diagnostic modalities include ultrasonography, CT, ERCP, PTC, and MRI/MRCP.
  • Extrahepatic choledochal cysts necessitate surgical management via radical excision.
  • Reconstructive techniques like Roux-Y hepaticojejunostomy facilitate future diagnostic and therapeutic access.

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Implications:

  • Early diagnosis and surgical intervention are crucial for managing choledochal cysts in adults.
  • Radical excision and appropriate reconstruction lead to favorable long-term patient outcomes.
  • Awareness of malignant potential underscores the importance of timely management.