An impressive choledochal cyst and its surgical resection

Area of Science:

• Gastroenterology
• Hepatobiliary Surgery
• Medical Diagnostics

Background:

• Choledochal cysts are rare congenital biliary tree dilations.
• Symptoms like abdominal pain, jaundice, and pancreatitis are non-specific, complicating adult diagnosis.
• Delayed diagnosis can lead to recurrent infections, stones, and biliary obstruction.

Purpose of the Study:

• To highlight the diagnostic challenges of choledochal cysts in adults.
• To emphasize the importance of considering choledochal cysts in the differential diagnosis of persistent biliary symptoms.
• To underscore the benefits of advanced imaging in early detection and management.

Main Methods:

• Case presentation of a 50-year-old woman with recurrent biliary issues post-cholecystectomy.
• Review of diagnostic workup including ultrasound and ERCP.
• Surgical intervention involving cyst excision and Roux-en-Y hepaticojejunostomy.

Main Results:

• The patient presented with persistent symptoms attributed to chronic cholecystitis and choledocholithiasis.
• ERCP revealed a common bile duct dilation consistent with a choledochal cyst and multiple stones.
• Surgical excision and reconstruction resulted in a positive post-operative outcome.

Conclusions:

• Choledochal cysts can present insidiously with recurrent biliary problems, even after cholecystectomy.
• MRCP could have facilitated earlier diagnosis and potentially avoided prolonged symptoms and interventions.
• Early diagnosis and surgical excision are essential due to the increased risk of malignancy associated with choledochal cysts.