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[Choledochal cyst associated with dominant dorsal duct syndrome: report of two cases]
Insights
This study reports two infant cases of choledochal cysts with dominant dorsal ducts. Intraoperative cholangiopancreatography confirmed this rare association, highlighting the need for careful diagnosis.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Anatomical Variations
Background:
- Choledochal cysts are congenital dilations of the bile ducts, often presenting in infancy.
- Associated anomalies, such as pancreaticobiliary maljunction, are common.
- Dominant dorsal ducts represent a significant anatomical variation within the biliary system.
Observation:
- Two male infants presented with symptoms suggestive of choledochal cysts, including abdominal distention, vomiting, and fever.
- Both patients underwent surgical intervention based on clinical suspicion.
- Intraoperative cholangiopancreatography revealed the presence of dominant dorsal ducts in both cases.
Findings:
- The study identified a rare association between choledochal cysts and dominant dorsal ducts.
- This anatomical variation was confirmed intraoperatively using cholangiopancreatography.
- The clinical presentation in both infants mimicked typical choledochal cyst symptoms.
Implications:
- Accurate preoperative diagnosis and intraoperative assessment are crucial for managing choledochal cysts with complex ductal anatomy.
- Understanding the prevalence of dominant dorsal ducts in choledochal cysts can refine surgical approaches.
- Further research into the embryological basis of this association may improve understanding of biliary tract development.
Abstract:
Two cases with choledochal cysts associated with dominant dorsal ducts were reported. The first patient, a male infant, presented with abdominal distention and vomiting for two days at the age of four months. The second patient, nine month-old male infant, presented with fever for one day, irritability, post-prandial vomiting and preference for lying in a left lateral decubitus position. Both cases were operated under the impression of choledochal cysts, and were found by intraoperative cholangiopancreatography to have dominant dorsal ducts. These two cases and the literature concerning choledochal cyst associated with dominant dorsal duct are reviewed.