University of Virginia School of Medicine, Charlottesville, Virginia, USA
Pediatric Gastroenterology, University of Virginia Health System, Charlottesville, Virginia, USA.
BMJ Case Rep. 2020 Jul 8;13(7):e234966. doi: 10.1136/bcr-2020-234966.
Choledochal cysts are dilations of the biliary tree that cause a variety of clinical symptoms and can lead to several types of complications. Choledochal cysts are most commonly diagnosed in childhood and frequently present with abdominal pain, jaundice and, in infants, an abdominal mass. Although the most concerning complication is malignant transformation of the cyst epithelium, other complications such as stone formation, acute pancreatitis and stricture can also occur and lead to patient morbidity. Treatment is aimed at not only relieving patient symptoms, but also decreasing a long-term cancer risk. We present a case of a child presenting with abdominal pain and vomiting secondary to a type IVa choledochal cyst complicated by acute pancreatitis, a common bile duct stricture and cystolithiasis.
胆总管囊肿是胆道树的扩张,可引起多种临床症状,并可导致多种类型的并发症。胆总管囊肿最常见于儿童期,常表现为腹痛、黄疸,婴儿则表现为腹部肿块。尽管最令人担忧的并发症是囊肿上皮的恶性转化,但其他并发症,如结石形成、急性胰腺炎和狭窄,也可能发生,并导致患者发病。治疗的目的不仅是缓解患者的症状,还要降低长期的癌症风险。我们报告了一例儿童病例,因 IVa 型胆总管囊肿引起腹痛和呕吐,伴有急性胰腺炎、胆总管狭窄和胆石症。