A Unique and Rare Presentation of Obstructed Choledochal Cyst in an Adult: A Case Report

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Authors

  • Ahmad E. Al-Mulla Department of Surgery, Farwaniya Hospital, Ministry of Health Kuwait, Farwaniya, Kuwait
  • Salah Termos Hepato-Biliary and Pancreas and General Surgery, Al- Amiri Hospital, Kuwait City, Kuwait
  • Fawzia Ashkanani Department of Surgery, Farwaniya Hospital, Ministry of Health Kuwait, Farwaniya, Kuwait
  • Ehab S. Imam Department of Surgery, Farwaniya Hospital, Ministry of Health Kuwait, Farwaniya, Kuwait
  • Abdulla E. Sultan Department of Surgery, Farwaniya Hospital, Ministry of Health Kuwait, Farwaniya, Kuwait
  • Ali Altabeekh Department of Surgery, Farwaniya Hospital, Ministry of Health Kuwait, Farwaniya, Kuwait
  • Mohammad Y. Saleh Department of Surgery, Farwaniya Hospital, Ministry of Health Kuwait, Farwaniya, Kuwait
  • Ahmad Al-Jafar Department of Surgery, Farwaniya Hospital, Ministry of Health Kuwait, Farwaniya, Kuwait

DOI:

https://doi.org/10.17140/SROJ-6-127

Keywords:

Choledochal cyst, Hepato-jejunal anastomosis, Biliary system anomaly, Choledochal cyst in adults

Abstract

Choledochal cysts in adults are rare congenital abnormalities. Approximately 80% are found in childhood. Thus, their presentation in adults is always associated with complications, such as stone formation, inflammation and malignancies. The pathophysiology of this disease is yet uncertain. There are different types of choledochal cysts. Diagnosis can be challenging clinically; however, imaging techniques, such as ultrasound, magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT), can be helpful. We found several procedures performed in the extant literature, such as choledochoduodenostomy and choledochojejunostomy submucosal excision of the cyst; however, the best surgical option is excision with hepaticojejunostomy. We discuss the unusual presentation of a 33-year-old female patient with an obstructed choledochal cyst, despite having undergone a drainage procedure in childhood.

References

Mann CV, Russell RCG. Gall bladder and bile duct. In: Russell RCG, ed. Bailey and Love Short Practice of Surgery. 23rd ed. London, UK: Chapman and Hall; 2000: 973-994.

Baison GN, Bonds MM, Helton WS, Kozarek RA. Choledo-chal cysts: Similarities and differences between Asian and West-ern countries. World J Gastroenterol. 2019; 25(26): 3334-3343. doi: 10.3748/wjg.v25.i26.3334

Kumar M, Rajagopalan S. Choledochal cyst. Med J Armed Forces India. 2012; 68(3): 296-298. doi: 10.1016/j.mjafi.2012.04.011

de Albuquerque VVML, De Macedo FP, Costa KG, Nunes ZRS, da Silva Junior RA. Choledochal cyst - unusual presentation in the adult phase: Case report. Int J Surg Case Rep. 2020; 70: 33-36. doi: 10.1016/j.ijscr.2020.03.014

Stringer MD, Dhawan A, Davenport M, Mieli-Vergani G, Mo-wat AP, Howard ER. Choledochal cysts: Lessons from a 20-year experience. Arch Dis Child. 1995; 73(6): 528-531. doi: 10.1136/ adc.73.6.528

Burkhalter E. Choledochal cyst. A case report. Am Surg. 1990; 56(6): 377-379.

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

Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Con-genital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from chole-dochal cyst. Am J Surg. 1977; 134(2): 263-269. doi: 10.1016/0002- 9610(77)90359-2

Singham J, Yoshida EM, Scudamore CH. Choledochal cysts: part 1 of 3: Classification and pathogenesis. Can J Surg. 2009; 52(5): 434-440.

Dahiya D, Raman K, Singh H. Neuroendocrine tumor in chole-dochal cyst – case report and review of literature. Pol Przegl Chir. 2011; 83: 627-629. doi: 10.2478/v10035-011-0099-0

Dhupar R, Gulack B, Geller DA, Marsh JW, Gamblin TC. The changing presentation of choledochal cyst disease: An incidental diagnosis. HPB Surg. 2009; 2009: 1037-1039. doi: 10.1155/2009/103739

Singham J, Yoshida EM, Scudamore CH. Choledochal cysts: Part 2 of 3: Diagnosis. Can J Surg. 2009; 52: 506-511.

Chijiiwa K, Koga A. Surgical management and long-term fol-low-up of patients with choledochal cysts. Am J Surg. 1993; 165(2): 238-242. doi: 10.1016/s0002-9610(05)80518-5 Submit your article to this journal | https://openventio.org/submit-manuscript/ 16 Al-Mulla AE et al

Govil S, Justus A, Korah I, Perakath A, Zachariah N, Sen S. Choledochal cysts: Evaluation with MR cholangiography. Abdom Imaging. 1998; 23(6): 616-619. doi: 10.1007/s002619900415

Liu CL, Fan ST, Lo CM, Lam CM, Poon RT, Wong J. Choledo-chal cysts in adults. Arch Surg. 2002; 137(4): 465-468. doi: 10.1001/ archsurg.137.4.465

Metcalfe MS, Wemyss-Holden SA, Maddern GJ. Management dilemmas with choledochal cysts. Arch Surg. 2003; 138(3): 333-339. doi: 10.1001/archsurg.138.3.333 Case Report | Volume 6 | Number 1|

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Published

2021-11-11

How to Cite

Ahmad E. Al-Mulla, Salah Termos, Fawzia Ashkanani, Ehab S. Imam, Abdulla E. Sultan, Ali Altabeekh, … Ahmad Al-Jafar. (2021). A Unique and Rare Presentation of Obstructed Choledochal Cyst in an Adult: A Case Report. Surgical Research, 6(1), 13–16. https://doi.org/10.17140/SROJ-6-127

Issue

Vol. 6 No. 1 (2021): Volume 6 Issue 1 2021

Section

Articles

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