Bhattarai Pratik, Timilsina Bishowdeep, Khanal Prasun
Manipal College of Medical Sciences Pokhara Nepal.
Oxford University Clinical Research Unit Nepal Nepal.
Clin Case Rep. 2023 Sep 27;11(10):e7992. doi: 10.1002/ccr3.7992. eCollection 2023 Oct.
A choledochal cyst is a rare congenital anomaly of the biliary system, characterized by bile duct cystic dilatation, typically affecting the common bile duct. Choledochal cysts are generally categorized using the Todani classification system. The typical symptoms are jaundice, abdominal masses, and recurrent abdominal pain. As most cases are diagnosed in children, adult presentations are uncommon and often associated with complications. A 22-year-old female patient complained of severe abdominal pain and vomiting for 5 days, with signs of jaundice. Her abdominal ultrasound revealed fusiform dilation of the extrahepatic common bile duct with multiple calculi in its distal-most part. On CT cholangiogram of the abdomen, Type IV-A Choledochal cyst with non-obstructive choledocholithiasis was found. Although rare, choledochal cysts are a well-known clinical entity. It is essential to diagnose and treat patients because they may develop complications. Cholecystectomy combined with Roux-en-Y hepaticojejunostomy is the preferred treatment for Type IV-A choledochal cysts. Since choledochal cysts in adults are uncommon, early detection and treatment are essential to avoid serious complications. Ultrasonography (USG), Magnetic resonance cholangiopancreatography (MRCP), and Computed tomography (CT) can provide a diagnosis.
胆总管囊肿是一种罕见的先天性胆道系统异常，其特征为胆管囊性扩张，通常累及胆总管。胆总管囊肿一般采用托达尼分类系统进行分类。典型症状为黄疸、腹部肿块和反复腹痛。由于大多数病例在儿童期被诊断，成人发病并不常见，且常伴有并发症。一名22岁女性患者主诉严重腹痛和呕吐5天，伴有黄疸体征。她的腹部超声显示肝外胆总管梭形扩张，最远端有多个结石。腹部CT胆管造影发现IV - A型胆总管囊肿合并非梗阻性胆总管结石。尽管胆总管囊肿罕见，但却是一种广为人知的临床病症。对患者进行诊断和治疗至关重要，因为它们可能会引发并发症。胆囊切除术联合Roux - en - Y肝空肠吻合术是IV - A型胆总管囊肿的首选治疗方法。由于成人胆总管囊肿不常见，早期发现和治疗对于避免严重并发症至关重要。超声检查（USG）、磁共振胆胰管造影（MRCP）和计算机断层扫描（CT）均可提供诊断。
