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Choledochal cyst in neonates

H C Lai1, Y K Wu, H S Lai

  • 1Department of Pediatrics, Show-Chwan Memorial Hospital, Chang-Hua, Taiwan, ROC.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|July 1, 1996
PubMed
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Choledochal cysts are rare causes of neonatal jaundice, often mimicking biliary atresia. Early detection and surgical treatment of these common bile duct cysts are crucial for preventing complications.

Area of Science:

  • Pediatric Surgery
  • Neonatal Gastroenterology
  • Hepatobiliary Surgery

Background:

  • Choledochal cysts are uncommon causes of neonatal jaundice.
  • They often present with clinical features indistinguishable from biliary atresia.
  • Neonatal presentation necessitates prompt diagnosis and management.

Observation:

  • Two cases of neonatal choledochal cyst are presented.
  • Infants exhibited prolonged jaundice without perinatal insult.
  • Antenatal ultrasound was unremarkable; biochemical tests showed elevated liver enzymes and direct bilirubin.

Findings:

  • Abdominal sonography revealed a cystic mass near the gallbladder; one patient had intrahepatic duct dilation.
  • Hepatobiliary scintigraphy showed radionuclide accumulation in the porta hepatis without intestinal transit.

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  • Surgical findings confirmed cystic dilatation of the common bile duct with distal obstruction.

    • Implications:

    • Surgical management involved cyst excision with Roux-en-Y hepaticojejunostomy and cholecystectomy.
    • Postoperative courses were uneventful, with one liver biopsy showing mild bile duct proliferation and portal fibrosis.
    • Early diagnosis and treatment of neonatal choledochal cysts are vital to avert severe biliary obstruction complications.