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Choledochal cyst associated with acute acalculous cholecystitis
1Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China.
Journal of Pediatric Gastroenterology and Nutrition
|September 21, 2000
Summary
A pediatric patient presented with suspected appendicitis but was found to have a choledochal cyst. Surgical intervention and follow-up confirmed the cyst
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Abdominal Imaging
Background:
- Acute appendicitis is a common surgical emergency in children.
- Bile peritonitis and gallbladder hydrops can present with non-specific abdominal symptoms.
- Choledochal cysts are congenital dilations of the bile ducts, often presenting in childhood.
Observation:
- A 7-year-old girl presented with symptoms suggestive of acute appendicitis.
- Laparotomy revealed bile peritonitis and gallbladder hydrops, with a normal appendix.
- Intraoperative cholangiography identified common bile duct (CBD) dilatation, confirming a choledochal cyst.
Findings:
- The patient underwent cholecystectomy and T-tube placement.
- Postoperative ultrasound monitoring for 9 months showed a stable CBD diameter.
- No clinical manifestations related to the choledochal cyst were observed post-surgery.
Implications:
- This case highlights the importance of considering choledochal cysts in pediatric patients with atypical abdominal presentations.
- Early diagnosis and surgical management of choledochal cysts are crucial for preventing complications.
- Multimodality imaging, including intraoperative cholangiography and ultrasound, plays a vital role in diagnosis and follow-up.