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Updated: Apr 20, 2026

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Published on: February 28, 2025

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Spontaneous choledochal cyst perforation in pregnancy with co-existent chronic pancreatitis

Harjeet Singh1, Rahul Gupta1, Lakhbir Dhaliwal2

  • 1Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

BMJ Case Reports
|November 16, 2014
PubMed

Insights

Spontaneous choledochal cyst perforation during pregnancy is rare but manageable. A two-stage surgical approach involving T-tube drainage and later cyst excision successfully treated a pregnant patient.

Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery
  • Obstetrics

Background:

  • Choledochal cysts are congenital bile duct anomalies, often presenting in childhood.
  • Weakened bile duct walls predispose to spontaneous perforation due to obstruction, infection, or reflux.

Observation:

  • A 25-year-old pregnant woman (35 weeks gestation) presented with acute abdominal and fetal distress.
  • Emergency laparotomy revealed common bile duct perforations, necessitating T-tube drainage and caesarean section.

Findings:

  • A T-tube cholangiogram confirmed a choledochal cyst with an abnormal pancreatobiliary junction and chronic pancreatitis.
  • The patient underwent successful two-stage management: initial drainage followed by cyst excision with Roux en Y hepaticojejunostomy.

Implications:

  • Spontaneous choledochal cyst perforation in pregnancy is a critical condition requiring prompt surgical intervention.
  • A staged surgical approach can lead to successful outcomes for both mother and fetus in such complex cases.

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