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Published on: February 28, 2025

Traumatic rupture of choledochal cyst in a child

Itsuro Nagae1, Akihiko Tsuchida, Yoshihide Tanabe

  • 1Third Department of Surgery, Tokyo Medical University, Tokyo 160-0023, Japan. i-nagae@tokyo-med.ac.jp

Journal of Pediatric Surgery
|March 8, 2005
PubMed

Insights

Traumatic rupture of a choledochal cyst, a rare condition, occurred in a 4-year-old boy after abdominal trauma. Surgical repair revealed a 2mm rupture in the common bile duct, highlighting the need for careful intraoperative examination.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Abdominal Trauma

Background:

  • Choledochal cysts are congenital dilations of the biliary tree.
  • Traumatic rupture of a choledochal cyst is exceptionally rare.
  • Pancreaticobiliary maljunction is a recognized risk factor.

Observation:

  • A 4-year-old boy sustained abdominal trauma from a fall.
  • Percutaneous transhepatic cholangiography identified pancreaticobiliary maljunction.
  • Moderate peritoneal inflammation was noted during surgery.

Findings:

  • Initial surgery involved choledochal cyst excision and hepaticojejunostomy.
  • A 2 mm diameter rupture was discovered on the posterior aspect of the common bile duct.
  • This finding occurred during the primary surgical procedure.

Implications:

  • Highlights the importance of meticulous intraoperative inspection in suspected choledochal cyst injuries.
  • Underscores the potential for bile duct rupture secondary to blunt abdominal trauma.
  • Suggests that pancreaticobiliary maljunction may predispose to cyst rupture.

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