Gupta Ashish, Chakaravarthi Karikal, Kaman Lileswar
Department of General Surgery, PGIMER, Chandigarh 160012, India.
Gastroenterology Res. 2017 Apr;10(2):128-131. doi: 10.14740/gr781w. Epub 2017 Apr 19.
With the advent of newer radiological investigations, choledochal cysts are being diagnosed more often in present era. These cysts are commonly diagnosed in early childhood and infancy, although some go undetected to be diagnosed in adulthood. These malformations are associated with multiple complications like cholangitis, jaundice, pancreatitis, rupture or even malignancy. Here we describe a post partum female, who was diagnosed to have choledochal cyst during sixth month of pregnancy. She presented with obstructive jaundice in cholangitis and was subjected to endoscopic retrograde cholangiopancreatography (ERCP) with stenting. This female delivered normally at term. She again had jaundice with cholangitis during early post partum period. Endoscopic stenting could be performed. She had features of peritonitis after 1 week of stenting. Investigations were performed and a diagnosis of spontaneous rupture of choledochal cyst was made. She underwent laparotomy and lavage with complete excision of the choledochal cyst and Roux-en-Y hepaticojejunostomy.
随着更新的放射学检查方法的出现,在当今时代,胆总管囊肿的诊断越来越频繁。这些囊肿通常在儿童早期和婴儿期被诊断出来,尽管有些囊肿直到成年才被发现。这些畸形与多种并发症相关,如胆管炎、黄疸、胰腺炎、破裂甚至恶性肿瘤。在此,我们描述一位产后女性,她在怀孕第六个月时被诊断出患有胆总管囊肿。她因胆管炎出现梗阻性黄疸,并接受了内镜逆行胰胆管造影(ERCP)及支架置入术。该女性足月顺产。产后早期她再次因胆管炎出现黄疸。可进行内镜支架置入术。支架置入1周后她出现腹膜炎症状。进行了相关检查,诊断为胆总管囊肿自发性破裂。她接受了剖腹探查和灌洗,同时完整切除胆总管囊肿并进行了Roux-en-Y肝空肠吻合术。