J Korean Surg Soc.  2010 Feb;78(2):123-126. 10.4174/jkss.2010.78.2.123.

Type IV-A Choledochal Cyst with Intrahepatic Bile Duct Stricture

• Hong SK

• KMID: 2096567
• DOI: http://doi.org/10.4174/jkss.2010.78.2.123

Abstract

Choledochal cysts are rare congenital anomalies of the bile ducts. They consist of cystic dilatations of the extrahepatic biliary tree, intrahepatic radicles, or both. The standard treatment of choledochal cyst is complete excision of cyst and drainage procedure. I report a case of 48-year-old women who was diagnosed with type IV-A choledochal cyst with intrahepatic bile duct stricture and large stones in extrahepatic choledochal cyst. Sixteen years ago, she received a cholecystectomy and Reux-en Y cystojejunostomy due to choledochal cyst. Because of the intrahepatic bile duct stricture I performed a left hepatectomy, complete cyst excision and hepaticojejunostomy. I report this case with a review of the literature.

Keyword

Choledochal cyst; Bile duct stricture; Hepatectomy

MeSH Terms

Bile Ducts
Bile Ducts, Intrahepatic
Biliary Tract
Cholecystectomy
Choledochal Cyst
Constriction, Pathologic
Dilatation
Drainage
Female
Hepatectomy
Humans
Middle Aged

Figure

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  Fig. 1 Abdominal CT scan showed left hepatic cyst and cystic dilatation of central IHD and proximal 1/2 CBD with internal fuge stone- possible stones in IHD and CBD with underlying choledochal cyst.

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  Fig. 2 MRI showed moderate to severe dilatation of central IHD and extrahepatic duct, especially cystic dilatation in left central IHD mimicking left hepatic cyst or biliary cystadenoma.

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  Fig. 3 CT scan showed contrast filled the left hepatic cyst.

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  Fig. 4 Resection line.

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  Fig. 5 There is a non-epithelial and dilated intrahepatic duct without epithelial lining. The fibrosis and inflammatory cell infiltration are present in the wall (arrow) (H&E, ×100).

Reference

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