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Ruptured choledochal cyst: recognition and management.

The Australian and New Zealand Journal of Surgery

|October 1, 1978

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A ruptured choledochal cyst caused by trauma required emergency biliary drainage and surgical repair. A Roux-en-Y cystjejunostomy ensured long-term recovery for this rare bile duct injury.

Area of Science:

Gastroenterology and Hepatobiliary Surgery
Trauma Surgery
Abdominal Imaging

Background:

Choledochal cysts are rare congenital bile duct dilatations.
Rupture of a choledochal cyst is an uncommon but serious complication.
Traumatic injury can precipitate choledochal cyst rupture.

Observation:

A 21-year-old male sustained a traumatic bile duct injury following a motor vehicle accident.
Laparotomy revealed hemoperitoneum from a bile-stained hematoma in the omentum and mesocolon.
The source was identified as a longitudinally ruptured choledochal cyst with gallbladder communication.

Findings:

Initial management involved Foley catheterization of the common hepatic duct for biliary drainage.
Postoperative cholangiography demonstrated significant intrahepatic ductal dilation.

Related Experiment Videos

A definitive Roux-en-Y cystjejunostomy was performed 5 days post-injury.

Implications:

Prompt recognition and primary biliary drainage are critical for managing traumatic choledochal cyst rupture.
Staged management may be necessary for critically ill patients.
End-to-end cystjejunostomy offers a successful long-term biliary reconstruction method.