Spontaneous Rupture of a Choledochal Cyst During Post Partum: A Rare Presentation

With the advent of newer radiological investigations, choledochal cysts are being diagnosed more often in present era. These cysts are commonly diagnosed in early childhood and infancy, although some go undetected to be diagnosed in adulthood. These malformations are associated with multiple complications like cholangitis, jaundice, pancreatitis, rupture or even malignancy. Here we describe a post partum female, who was diagnosed to have choledochal cyst during sixth month of pregnancy. She presented with obstructive jaundice in cholangitis and was subjected to endoscopic retrograde cholangiopancreatography (ERCP) with stenting. This female delivered normally at term. She again had jaundice with cholangitis during early post partum period. Endoscopic stenting could be performed. She had features of peritonitis after 1 week of stenting. Investigations were performed and a diagnosis of spontaneous rupture of choledochal cyst was made. She underwent laparotomy and lavage with complete excision of the choledochal cyst and Roux-en-Y hepaticojejunostomy.