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Choledochal cysts and multilocular cysts of the pancreas
Xiu Yan Xie1, Eric Strauch, Chen-Chih J Sun
1Department of Pathology and Department of Pediatric Surgery, University of Maryland, Baltimore, MD, USA.
Insights
Choledochal cysts, rare congenital biliary anomalies, can present with pancreatic cysts. This case highlights pancreatic cysts as part of the spectrum of abnormalities associated with choledochal cysts.
Area of Science:
- Gastroenterology and Hepatology
- Pediatric Surgery
- Congenital Anomalies
Background:
- Choledochal cysts are rare congenital biliary tract malformations.
- They can be associated with other hepatobiliary abnormalities.
- Understanding the full spectrum of associated anomalies is crucial for diagnosis and management.
Observation:
- A case report of an 11-year-old boy with a diagnosed choledochal cyst.
- Intraoperative cholangiopancreatography revealed an additional cystic mass within the pancreas.
- Surgical specimen analysis confirmed a multilocular pancreatic cyst alongside common bile duct dilation.
Findings:
- The presence of a pancreatic cyst expands the known spectrum of anomalies linked to choledochal cysts.
- This finding supports the hypothesis of a widespread pancreatobiliary ductal dysplasia spectrum where choledochal cysts are a primary manifestation.
Implications:
- Suggests a broader classification of congenital pancreatobiliary anomalies.
- Emphasizes the need for thorough evaluation of the pancreas in patients with choledochal cysts.
- May refine understanding of the developmental origins of pancreatobiliary ductal anomalies.
Abstract:
Choledochal cyst is a rare congenital anomaly of the biliary system that may be associated with other abnormalities of the hepatobiliary tract. We report a case of an 11-year-old boy in whom the preoperative evaluation revealed a choledochal cyst and intraoperative cholangiopancreatography showed a cystic mass in the pancreas. Examination of the choledocho-pancreatico-duodenectomy specimen showed a multilocular cyst in the pancreas in addition to a segmental dilation of the common bile duct. The findings in our case adds pancreatic cyst to the spectrum of abnormalities associated with choledochal cyst and may also support the theory that choledochal cyst is the predominant abnormality in a widespread spectrum of the pancreatobiliary duct dysplasia.