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.
Similar content being viewed by others
References
Stain SC, Guthrie CR, Yellin AE, Donovan AJ (1995) Choledochal cyst in the adult. Ann Surg 222:128–133
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
Lal R, Agarwal S, Shivhare R et al (2007) Management of complicated choledochal cysts. Dig Surg 24:456–462
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
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
Komuro H, Makino S, Tahara K (2000) Choledochal cyst associated with duodenal obstruction. J Pediatr Surg 35:1259–1262
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
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
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
Maheshwari M, Parekh BR, Lahoti BK (2002) Biliary peritonitis: a rare presentation of perforated choledochal cyst. Indian Pediatr 39:588–592
Moss RL, Musemeche CA (1997) Successful management of ruptured choledochal cyst by primary cyst excision and biliary reconstruction. J Pediatr Surg 10:1490–1491
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
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
Farrell WJ (1959) Giant choledochal cyst; report of a case successfully treated by Roux-en-Y choledochocyst-jejunostomy. Ann Surg 150:313–319
Holland AJ, Childs PA (1996) Case report: giant choledochal cyst. J Gastroenterol Hepatol 11:847–849
Anand U, Priyadarshi RN, Kumar B (2012) A giant type IVA choledochal cyst. Ann Gastroenterol 25:73–75
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
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
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
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
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
Michaelides M, Dimarelos V, Kostentinou D et al (2011) A new variant of Todani type I choledochal cyst. Imaging evaluation. Hippokratia 15:174–177
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
Conflict of Interest
The authors declare no potential conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-014-1156-9