Choledochalcyst
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A 6-year-old female presented with right flank pain. Imaging showed dilatation of the common bile duct consistent with a choledochal cyst. She underwent surgery where a choledochal cystectomy and Roux-en-Y hepaticojejunostomy was performed. Pathology confirmed a type 1a choledochal cyst. Post-operatively, her recovery was uneventful.
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Choledocal cyst
Choledochal cysts are dilations of the common bile duct. They are most commonly diagnosed in children under 10 years old and can present with abdominal pain, jaundice, or mass. Imaging like ultrasound, CT, MRCP, and cholangiography are used to diagnose and characterize the cyst type. Complete surgical excision and biliary-enteric anastomosis is the treatment of choice to prevent complications like cholangitis, pancreatitis, and cholangiocarcinoma. Long term follow up is needed due to risk of recurrent issues and malignancy.
Choledochal cysts - Introduction, Classification, Pathogenesis & Management
Choledochal cysts - Introduction, Classification, Pathogenesis & ManagementNepal Medical College and Teaching Hospital
PowerPoint presentation on Choledochal Cysts, also known as biliary cyst, uploaded by Dr. Vaskar Humagain, first presented in 31st December, 2013. This presentation contains all the information about Choledochal Cysts, the original and revised Todani classification of choledochal cysts, pathogenesis, other associated congenital anomalies, clinical features in infant and adult, management of choledochal cysts. Comments are highly welcome :)Choledochal cyst
- A 13-year-old female presented with epigastric pain and vomiting for the past 2 years. Imaging showed a cystic area in the common bile duct. MRCP revealed a well-defined cystic lesion with calculi, suggestive of a choledochal cyst type 2.
- The patient underwent excision of the choledochal cyst with Roux-en-Y loop formation. Post-op recovery was uneventful.
- Choledochal cysts are rare congenital dilations of the biliary tree that are more common in females. Complete surgical excision is the recommended treatment to prevent complications like cholangiocarcinoma.
Choledochal cyst
Choledochal cysts are rare, usually diagnosed in children and involve pathological dilatation of the biliary system. They are classified into 5 types based on location and appearance. Type 1 cysts involve the extrahepatic bile duct and are the most common. Diagnosis involves imaging like ultrasound, CT, MRCP and sometimes cholangiography. Treatment is complete surgical excision to prevent malignancy, with Roux-en-Y hepaticojejunostomy for biliary reconstruction. Long term follow up is needed due to risk of malignancy and anastomotic strictures.
Cystic liver lesions - An ultrasound perspective
This document summarizes the diagnosis and imaging findings of various cystic hepatic lesions. It describes simple hepatic cysts, hydatid cysts, and congenital fibrocystic liver diseases including biliary hamartomas, peribiliary cysts, choledochal cysts, and polycystic liver disease. Imaging findings on ultrasound, CT, MRI, and MRCP are provided for each condition to aid diagnosis. Differential features between lesion types are emphasized, along with WHO classification of hydatid cyst appearance and post-operative evaluation of hydatid cyst treatment.
Choledochal cyst
Choledochal cysts are a premalignant condition involving cystic dilations of the biliary tree. They are classified into 5 types based on the location and extent of dilation. Type I cysts involve dilation of the extrahepatic bile duct and are the most common, comprising 50-80% of cases. The pathogenesis is thought to involve defects in bile duct remodeling during embryogenesis leading to obstruction and cyst formation. Clinical features vary with age but commonly include abdominal pain, jaundice and mass. Ultrasound is often the initial imaging but MRCP provides the most detail to characterize the cyst type and involvement.
Choledochal cyst
This Presentation gives general overview of how patient with Choledochal Cyst presents and what workup should be done and how such patients should be managed
Choledochal cyst
Choledochal cyst is a congenital abnormality of the biliary tree that results in dilatation of the bile ducts. It is most common in Asia, with various theories proposed for its pathogenesis including abnormalities in bile duct remodeling during embryogenesis or obstruction leading to cyst formation. Patients may present with jaundice, abdominal pain or a mass. Diagnosis is typically made using ultrasound, CT or MRCP imaging. Surgical excision of the cyst and biliary reconstruction is the primary treatment for types I-IV, while type III may be treated endoscopically and type V depends on extent of liver involvement.
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Choledocal cyst
Choledochal cysts are dilations of the common bile duct. They are most commonly diagnosed in children under 10 years old and can present with abdominal pain, jaundice, or mass. Imaging like ultrasound, CT, MRCP, and cholangiography are used to diagnose and characterize the cyst type. Complete surgical excision and biliary-enteric anastomosis is the treatment of choice to prevent complications like cholangitis, pancreatitis, and cholangiocarcinoma. Long term follow up is needed due to risk of recurrent issues and malignancy.
Choledochal cysts - Introduction, Classification, Pathogenesis & Management
Choledochal cysts - Introduction, Classification, Pathogenesis & ManagementNepal Medical College and Teaching Hospital
PowerPoint presentation on Choledochal Cysts, also known as biliary cyst, uploaded by Dr. Vaskar Humagain, first presented in 31st December, 2013. This presentation contains all the information about Choledochal Cysts, the original and revised Todani classification of choledochal cysts, pathogenesis, other associated congenital anomalies, clinical features in infant and adult, management of choledochal cysts. Comments are highly welcome :)Choledochal cyst
- A 13-year-old female presented with epigastric pain and vomiting for the past 2 years. Imaging showed a cystic area in the common bile duct. MRCP revealed a well-defined cystic lesion with calculi, suggestive of a choledochal cyst type 2.
- The patient underwent excision of the choledochal cyst with Roux-en-Y loop formation. Post-op recovery was uneventful.
- Choledochal cysts are rare congenital dilations of the biliary tree that are more common in females. Complete surgical excision is the recommended treatment to prevent complications like cholangiocarcinoma.
Choledochal cyst
Choledochal cysts are rare, usually diagnosed in children and involve pathological dilatation of the biliary system. They are classified into 5 types based on location and appearance. Type 1 cysts involve the extrahepatic bile duct and are the most common. Diagnosis involves imaging like ultrasound, CT, MRCP and sometimes cholangiography. Treatment is complete surgical excision to prevent malignancy, with Roux-en-Y hepaticojejunostomy for biliary reconstruction. Long term follow up is needed due to risk of malignancy and anastomotic strictures.
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This document summarizes the diagnosis and imaging findings of various cystic hepatic lesions. It describes simple hepatic cysts, hydatid cysts, and congenital fibrocystic liver diseases including biliary hamartomas, peribiliary cysts, choledochal cysts, and polycystic liver disease. Imaging findings on ultrasound, CT, MRI, and MRCP are provided for each condition to aid diagnosis. Differential features between lesion types are emphasized, along with WHO classification of hydatid cyst appearance and post-operative evaluation of hydatid cyst treatment.
Choledochal cyst
Choledochal cysts are a premalignant condition involving cystic dilations of the biliary tree. They are classified into 5 types based on the location and extent of dilation. Type I cysts involve dilation of the extrahepatic bile duct and are the most common, comprising 50-80% of cases. The pathogenesis is thought to involve defects in bile duct remodeling during embryogenesis leading to obstruction and cyst formation. Clinical features vary with age but commonly include abdominal pain, jaundice and mass. Ultrasound is often the initial imaging but MRCP provides the most detail to characterize the cyst type and involvement.
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This Presentation gives general overview of how patient with Choledochal Cyst presents and what workup should be done and how such patients should be managed
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Choledochal cyst is a congenital abnormality of the biliary tree that results in dilatation of the bile ducts. It is most common in Asia, with various theories proposed for its pathogenesis including abnormalities in bile duct remodeling during embryogenesis or obstruction leading to cyst formation. Patients may present with jaundice, abdominal pain or a mass. Diagnosis is typically made using ultrasound, CT or MRCP imaging. Surgical excision of the cyst and biliary reconstruction is the primary treatment for types I-IV, while type III may be treated endoscopically and type V depends on extent of liver involvement.
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This document summarizes a seminar on choledochal cysts. It discusses the presentation, incidence, classification, investigations, complications and management of choledochal cysts. The key points are:
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1. Choledochal cysts are abnormal dilations of the bile ducts that are more common in Asia and women.
2. They are classified into 5 types based on location and extent of dilation.
3. Presentation varies from jaundice and abdominal mass in children to pain and cholangitis in older patients.
4. Investigation involves ultrasound, CT, MRCP and cholangiography to determine type and rule out complications.
5. Treatment is complete excision of the cysts and biliary tree with Roux-en-Y hepaticojejunostomy, except for type III which can be managed endoscopically.
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Choledochal cyst
The document summarizes a medical case involving a patient who presented with tenderness in the right hypochondrium. Laboratory tests revealed slightly elevated bilirubin levels and normal liver and pancreatic enzymes. Imaging found a double gallbladder with calculi. The patient underwent surgery where a bile duct cyst was discovered connected to the gallbladder, which contained well-differentiated papillary adenocarcinoma. Post-operatively drainage was bilious. The pathology report identified an anomalous pancreaticobiliary junction and chronic cholecystitis. Such junctions are associated with reflux of enzymes and may lead to choledochal cyst formation.
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Currently he is running “LOVE FOR SCALPEL” for PGMEE aspirants on most of the social platforms, which is gaining immense popularity among residents, medical graduates and undergraduates.
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3. Presentation varies from jaundice and abdominal mass in children to pain and cholangitis in older patients.
4. Investigation involves ultrasound, CT, MRCP and cholangiography to determine type and rule out complications.
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Focal vs diffuse gallbladder wall thickening can have different causes. [1] Focal thickening may be due to polyps, adenomyomatosis, carcinoma, or other conditions. [2] Diffuse thickening can result from conditions like cholecystitis, adenomyomatosis, or cancer. Imaging findings like wall thickness, presence of stones, diverticula, or masses help differentiate these conditions. Accurately diagnosing the cause of gallbladder wall thickening helps guide patient management.
Caroli syndrome
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Choledochalcyst
- 1. Choledochal CystCholedochal Cyst Sathish Babu MDSathish Babu MD
- 2. H & PH & P HPI- 6 year old female child DOA- 10/31/07HPI- 6 year old female child DOA- 10/31/07 Pain abdomen- Right flank since 3.30am, awakenPain abdomen- Right flank since 3.30am, awaken from sleepno pain in ER, loss of appetite-3 days,from sleepno pain in ER, loss of appetite-3 days, N/V + strep throat treated with amox 1 week agoN/V + strep throat treated with amox 1 week ago ROS- negativeROS- negative PMH-nonePMH-none PSH-nonePSH-none Immunization- up to dateImmunization- up to date Meds- AmoxicillinMeds- Amoxicillin Allergies- NoneAllergies- None
- 3. H & PH & P Exam- Vitals stable BP-113/65 HR-87 RR-28, Temp-Exam- Vitals stable BP-113/65 HR-87 RR-28, Temp- 36.1 SaO2-97%36.1 SaO2-97% Gen- pain free, active, cooperative, well nourished, noGen- pain free, active, cooperative, well nourished, no jaundice/cyanosis/pallor/lymphadenopathyjaundice/cyanosis/pallor/lymphadenopathy CVS- S1S2 normal , No S3S4/MurmersCVS- S1S2 normal , No S3S4/Murmers RS-CTARS-CTA Abd- Soft, mild RUQ tenderness+ ND. BS+Abd- Soft, mild RUQ tenderness+ ND. BS+ Ext- no edema, distal pulses well feltExt- no edema, distal pulses well felt Labs-normalLabs-normal
- 4. Labs & ImagingLabs & Imaging CT Scan- 10/31/07-Dilatation of CBD withCT Scan- 10/31/07-Dilatation of CBD with intrahepatic biliary duct dilatation.intrahepatic biliary duct dilatation. Patient on CLD , no pain, tolerating diet, stablePatient on CLD , no pain, tolerating diet, stable MRCP- 11/01/07- Cystic dilation of CHD andMRCP- 11/01/07- Cystic dilation of CHD and proximal CBD with a choledochal cyst, narrowingproximal CBD with a choledochal cyst, narrowing and stenosis at the junction of CHD with the cystand stenosis at the junction of CHD with the cyst and mild intrahepatic biliary dilatationand mild intrahepatic biliary dilatation GI consult- no choledochocoele- Surgery consult-GI consult- no choledochocoele- Surgery consult- 11/3/0811/3/08
- 5. Hospital CourseHospital Course d/c that we. Readmitted the following Mondayd/c that we. Readmitted the following Monday for bowel prep and surgery scheduled thefor bowel prep and surgery scheduled the following day (Tuesday)following day (Tuesday) Surgery- 11/6/08Type I Choledochal cyst,Surgery- 11/6/08Type I Choledochal cyst, Choledochocystectomy and Roux-en-YCholedochocystectomy and Roux-en-Y HepaticojejunostomyHepaticojejunostomy on epidural analgaesia- post op uneventfulon epidural analgaesia- post op uneventful JP drain removed on 3JP drain removed on 3rdrd day, d/c on 5day, d/c on 5thth PODPOD
- 6. PathologyPathology Final Pathologic Diagnosis: A: Gallbladder and choledochal cyst, excision: - Cystic duct with segmental saccular dilatation, consistent with choledochal cyst, type 1a (Todani classification) (see comment). - Gallbladder with no pathologic change. Comment: The cystic lesion shows lumenal continuation with the attached cystic duct and gallbladder. No epithelial dysplasia is seen.
- 7. CTCT ABDOMEN CT Lung bases clear. Solid organs are unremarkable. The gallbladder is normal. The common duct is quite dilated. Maximal diameter is about 1.8 cm. Length of dilatation is about 3.2 cm. There is associated mild intrahepatic duct dilatation. Findings are those of a choledochal cyst. Obstruction of the very distal portion of the common duct would be an additional possibility. PELVIC CT Normal IMPRESSION Prominent dilatation of common duct with intrahepatic biliary duct dilatation. Differential considerations are noted above. No other abnormalities are demonstrated. Dr. Kumar was notified of results by phone
- 11. MRIMRI Cystic dilatation of the distal common hepatic duct and proximal common bile duct consistent with a choledochal cyst. There appears to be some narrowing or stenosis at the junction of the common hepatic duct with the cyst and there is mild intrahepatic biliary dilatation. Otherwise negative.