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Unusual Presentations of Choledochal Cyst: Case Series and Review of Literature

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Abstract

Congenital cystic dilation of the biliary duct is defined as choledochal cyst (CDC). CDC presenting with the classical triad of abdominal pain, lump, and jaundice is seen in only 6 % cases. Cyst excision with hepaticojejunostomy is the standard treatment worldwide. We hereby report five cases of CDC with unusual presentations (gastric outlet obstruction, cyst perforation, giant cystolithiasis, giant cyst, and mixed type) and discuss the challenges faced during the diagnosis and perioperative management of these cases.

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References

  1. Stain SC, Guthrie CR, Yellin AE, Donovan AJ (1995) Choledochal cyst in the adult. Ann Surg 222:128–133

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Stringer MD, Dhawan A, Davenport M, Mieli-Vergani G, Mowat AP, Howard ER (1995) Choledochal cysts: lessons from a 20 year experience. Arch Dis Child 73:528–531

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Lal R, Agarwal S, Shivhare R et al (2007) Management of complicated choledochal cysts. Dig Surg 24:456–462

    Article  PubMed  Google Scholar 

  4. Alonso-Lej F, Rever WB Jr, Pessagno DJ (1959) Congenital choledochal cyst, with a report of 2, and an analysis of 94, cases. Int Abstr Surg 108:1–30

    CAS  PubMed  Google Scholar 

  5. Can MF, Kaymakçioğlu N, Yagci G, Gorgulu S, Tufan T (2006) An adult choledochocele case presented with gastric outlet obstruction: a rare presentation. Turk J Gastroenterol 17:70–73

    PubMed  Google Scholar 

  6. Komuro H, Makino S, Tahara K (2000) Choledochal cyst associated with duodenal obstruction. J Pediatr Surg 35:1259–1262

    Article  CAS  PubMed  Google Scholar 

  7. Iwai A, Hamada Y, Takada K et al (2009) Choledochal cyst associated with duodenal atresia: case report and review of the literature. Pediatr Surg Int 25:995–998

    Article  CAS  PubMed  Google Scholar 

  8. Ando K, Miyano T, Kohno S, Takamizawa S, Lane G (1998) Spontaneous perforation of choledochal cyst: a study of 13 cases. Eur J Pediatr Surg 8:23–25

    Article  CAS  PubMed  Google Scholar 

  9. Ando H, Ito T, Watanabe Y, Seo T, Kaneko K, Nagaya M (1995) Spontaneous perforation of choledochal cyst. J Am Coll Surg 181:125–128

    CAS  PubMed  Google Scholar 

  10. Maheshwari M, Parekh BR, Lahoti BK (2002) Biliary peritonitis: a rare presentation of perforated choledochal cyst. Indian Pediatr 39:588–592

    PubMed  Google Scholar 

  11. Moss RL, Musemeche CA (1997) Successful management of ruptured choledochal cyst by primary cyst excision and biliary reconstruction. J Pediatr Surg 10:1490–1491

    Article  Google Scholar 

  12. Singh S, Kheria LS, Puri S, Puri AS, Agarwal AK (2009) Choledochal cyst with large stone cast and portal hypertension. Hepatobiliary Pancreat Dis Int 8:647–649

    PubMed  Google Scholar 

  13. Hwang SO, Lee TH, Bae SH et al (2013) Diverticular choledochal cyst with a large impacted stone masquerading as Mirizzi’s syndrome. Case Rep Gastroenterol 7:164–168

    Article  PubMed  PubMed Central  Google Scholar 

  14. Farrell WJ (1959) Giant choledochal cyst; report of a case successfully treated by Roux-en-Y choledochocyst-jejunostomy. Ann Surg 150:313–319

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Holland AJ, Childs PA (1996) Case report: giant choledochal cyst. J Gastroenterol Hepatol 11:847–849

    Article  CAS  PubMed  Google Scholar 

  16. Anand U, Priyadarshi RN, Kumar B (2012) A giant type IVA choledochal cyst. Ann Gastroenterol 25:73–75

    PubMed  PubMed Central  Google Scholar 

  17. Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K (1977) Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg 134:263–269

    Article  CAS  PubMed  Google Scholar 

  18. Serena Serradel AF, Santamaría Linares E, Herrera Goepfert R (1991) Cystic dilatation of the cystic duct: a new type of biliary cyst. Surgery 109:320–322

    CAS  PubMed  Google Scholar 

  19. Kaneyama K, Yamataka A, Kobayashi H, Lane GJ, Miyano T (2005) Mixed type I and II choledochal cyst: a new clinical subtype? Pediatr Surg Int 21:911–913

    Article  PubMed  Google Scholar 

  20. Katsinelos P, Dimiropoulos S, Katsiba D et al (2003) Acute recurrent pancreatitis associated with anomalous pancreaticobiliary ductal union and choledochal cyst of mixed type I plus II. Surg Endosc 17:162

    CAS  PubMed  Google Scholar 

  21. Agarwal N, Kumar S, Hai A, Parfitt R (2009) Mixed type I and II choledochal cyst in an adult. Hepatobiliary Pancreat Dis Int 8:434–436

    PubMed  Google Scholar 

  22. Michaelides M, Dimarelos V, Kostentinou D et al (2011) A new variant of Todani type I choledochal cyst. Imaging evaluation. Hippokratia 15:174–177

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Siahaya FJ, Lalisang TJ, Jeo WS, Simanjuntak AB, Philippi B (2013) Uncommon mixed type I and II choledochal cyst: an Indonesian experience. Case Rep Surg. doi:10.1155/2013/821032

    PubMed  PubMed Central  Google Scholar 

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The authors declare no potential conflicts of interest.

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Correspondence to Abhijit Chandra.

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Gupta, N., Gupta, V., Noushif, M. et al. Unusual Presentations of Choledochal Cyst: Case Series and Review of Literature. Indian J Surg 77 (Suppl 3), 1318–1322 (2015). https://doi.org/10.1007/s12262-014-1156-9

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  • DOI: https://doi.org/10.1007/s12262-014-1156-9

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