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Choledochal Cyst in Children, presentation and outcome - 10 years' experience from a tertiary care center in Pakistan
Muhammad Arslan Farooq1, Sabeen Abid Khan2, Munir Iqbal Malik3
1Dr. Muhammad Arslan Farooq, MBBS, FCPS (Pediatrics). Senior Registrar, Pediatrics, Shifa Tameer-e-Millat University (Shifa College of Medicine)/ Shifa International Hospital, Islamabad, Pakistan.
Insights
Pediatric choledochal cysts present differently in infants versus older children. Surgical excision is the best treatment, and early intervention prevents complications.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Diagnostics
Background:
- Choledochal cysts are congenital bile duct anomalies with variable clinical presentations.
- Understanding age-specific features is crucial for timely diagnosis and management.
Purpose of the Study:
- To compare clinical features, laboratory findings, and surgical outcomes in infant and pediatric patients with choledochal cysts.
- To analyze the impact of age on presentation and complications.
Main Methods:
- Retrospective review of hospital records for pediatric patients diagnosed with choledochal cysts between 2011 and 2021.
- Patients were categorized into infant (<1 year) and pediatric (1-16 years) groups for comparative analysis.
Main Results:
- 34 children were included: 9 infants and 25 older pediatric patients. Type-I choledochal cysts were most common (73.5%).
- Infants commonly presented with jaundice (77.7%), while older children experienced abdominal pain (88%), vomiting (72%), and pancreatitis (32%).
- Overall post-surgical complication rate was 11.7%.
Conclusions:
- Choledochal cyst presentation varies significantly with patient age.
- Complete surgical excision is the preferred treatment, and prompt surgical intervention is key to preventing complications.
Objectives:
This study was done to compare the clinical features, laboratory findings and surgical outcomes of pediatric patients with choledochal cysts.
Methods:
Retrospective review of the hospital records of all pediatric patients admitted with choledochal cysts from 2011 to 2021 were collected and analyzed. Patients were divided into two groups; infant (less than one year age) and pediatric (1 to 16 years) for statistical comparison of two groups.
Result:
The study included 34 children, 9 (26.5%) were infant (<1 year) and 25 (73.5%) were more than one year old. Mean age at diagnosis was 15 months with age ranging from 14 days to 16 years. Females were 19 (55.9%) and males were 15 (44.1%). Type-I choledochal cyst was the most common (73.5%), presentation followed by Type-IVA (26.5%) in our patients. Patients from infant group presented with jaundice in 7 (77.7%), and clay-colored stool in 3 (33.3%) as the most common clinical features, while abdominal pain (88%), vomiting (72%), fever (32%) and pancreatitis (32%) were the frequent presentations among older age group. Post-surgical complications of excision of choledochal cyst were observed in 4 (11.7%) patients.
Conclusion:
Choledochal cysts have variable presentations depending upon age of the patients. Complete surgical excision of choledochal cyst is the treatment modality of choice and timely surgical management can prevent complications.
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