Ruptured choledochal cyst during early pregnancy with successful fetomaternal outcome

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Obstetrics and Gynecology
• Congenital Malformations

Background:

• Choledochal cysts are rare congenital biliary tract malformations typically diagnosed in childhood.
• While rare, choledochal cysts can present with serious complications including spontaneous rupture, particularly in adults.
• Pregnancy presents unique challenges for managing pre-existing conditions like choledochal cysts.

Observation:

• A rare case of spontaneous choledochal cyst rupture occurred during the second trimester of pregnancy.
• The patient presented with symptoms indicative of biliary peritonitis secondary to the rupture.
• The rupture occurred in a 2% subset of choledochal cyst complications.

Findings:

• The patient underwent minimal surgical intervention, including peritoneal washout and T-tube placement.
• The pregnancy was successfully continued to 35 weeks gestation following the intervention.
• Both maternal and fetal outcomes were favorable despite the intra-pregnancy complication.

Implications:

• This case demonstrates the feasibility of conservative surgical management for choledochal cyst rupture during pregnancy.
• It suggests that timely, minimal intervention can lead to favorable fetomaternal outcomes.
• Further research may explore optimal timing and methods for definitive treatment in postpartum periods.