Abstract
Excision of a choledochal cyst followed by biliary reconstruction with a Roux-en-Y hepaticojejunostomy is the treatment of choice for type I and IV choledochal cysts. We present a rare complication which was identified 8 years after the original reconstructive surgery. Conventional imaging modalities failed to identify the pathology. Only a contrast enhanced CT scan supported by image rendering software allowed for the visualization of the underlying chronic obstruction of part of the mesentery.
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Miyano T, Yamataka A, Kato Y, Segawa O, Lane G, Takamizawa S, Kohno S, Fujiwara T (1996) Hepaticoenterostomy after excision of Choledochal cyst in children: a 30-year experience with 180 cases. J Pediatr Surg 31:1417–1421
Shi LB, Peng SY, Meng XK, Peng CH, Liu YB, Chen XP, Ji ZL, Yang DT, Chen HR (2001) Diagnosis and treatment of congenital choledochal cyst: 20 years’ experience in China. World J Gastroenterol 7:732–734
Rha S-Y, Stovroff M C, Glick P L, Allen J E, Ricketts RR (1996) Choledochal cysts: a ten year experience. Am Surg 62:30–34
Rao KLN, Chowdhary SK, Kumar D (2003) Choledochal cyst associated with portal hypertension. Pediatric Surg Int 19:729–732
Siddiqui MM, Grier D, Cusick E (2006) Postnatal rupture of an antenatally diagnosed choledochal cyst: first case report. Acta Pediatr 95:115–117
Wagholikar GD, Chetri K, Yachha SK, Sikora SS (2004) Spontaneous perforation–a rare complication of choledochal cyst. Indian J Gastroenterol 23:111–112
Roux C (1893) De la gastroenterostomie. Revue de chirurgie 13:402–403
Chijiiwa K, Koga A (1993) Surgical management and longterm follow-up of patients with choledochal cysts. Am J Surg 165:238–242
Takada K, Hamada Y, Watanabe K, Tanano A, Tokuhara K, Kamiyama Y (2005) Duodenogastric reflux following biliary reconstruction after excision of choledochal cyst. Pediatr Surg Int 21:1–4
Todani T, Watanabe Y, Mizuguchi T, Fujii T, Toki A (1981) Hepaticoduodenostomy at the hepatic hilum after excision of choledochal cyst. Am J Surg 142:584–587
Shimotakahara A, Yamataka A, Yanai T, Kobayashi H, Okazaki T, Lane GJ, Miyano T (2005) Roux-en-Y heapticojejunostomy or Hepaticoduodenostomy for biliary reconstruction during the surgical treatment of choledochal cyst; which is better? Pediatr Surg Int 21:5–7
Ohi R, Yaoita S, Kamiyama T, Ibrahim M, Hayashi Y, Chiba T (1990) Surgical treatment of congential dilatation of the bile duct with special reference to late complications after total excisional operation. J Pediatr Surg 25:613–617
Yamataka A, Ohshiro K, Okada Y, Hosoda Y, Fujiwara T, Kohno S, Sunagawa M, Futagawa S, Sakakibara N, Miyano T (1997) Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pediatr Surg 32:1097–1102
Ajjiki T, Suzuki Y, Okazaki T, Fujino Y, Yoshikawa T, Sawa H, Hirata K, Kuroda Y (2006) A large stone detected in Roux-en-Y jejunal limb 20 years after excision of congenital choledochal cyst. Surgery 139:129–130
Malhorta RS, Jain A, Prabu RY, Kantharia CV, Madivale CV, Supe A (2005) Ischemic stricture of Roux-en-Y intestinal loop and recurrent cholangitis. Indian J Gastroenterol 24:76–77
Li L, Feng W, Jing-Bo F, Qi-Zhi Y, Gang L, Liu-Ming H, Yu L, Jun J, Ping W (2004) Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy. J Pediatr Surg 39:1663–1666
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Houben, C.H., Chan, M., Cheung, G. et al. A hepaticojejunostomy: technical errors with ‘twists and turns’. Pediatr Surg Int 22, 841–844 (2006). https://doi.org/10.1007/s00383-006-1729-1
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DOI: https://doi.org/10.1007/s00383-006-1729-1