Choledochal cyst: a case report
DOI:
https://doi.org/10.24265/horizmed.2025.v25n1.12Keywords:
Case Reports, Choledochal Cyst , General SurgeryAbstract
A choledochal cyst is a cystic dilatation that affects both the intrahepatic and extrahepatic biliary tree. The most commonly used classification to describe this pathology is that of Todani et al. (1997), which includes five categories. It is usually asymptomatic, but may present with symptoms such as abdominal pain, jaundice and fever. The gold standard for diagnosis is magnetic resonance cholangiopancreatography (MRCP). Patients with choledochal cysts have an increased risk of carcinogenesis. The neoplasms most commonly associated with choledochal cysts are cholangiocarcinoma and gallbladder cancer. Type I and V cysts are the most likely to undergo malignant transformation, while it is rarer in types II and III. Treatment consists of the surgical excision of the cyst with Roux-en-Y biliodigestive reconstruction. The laparoscopic approach is currently the most commonly used. Biliary drainage reconstruction is primarily performed using the Roux-en-Y procedure with hepaticojejunostomy (HJ) or hepaticoduodenostomy (HD). The literature on the choice of anastomosis and its benefits for the patient is limited. Several factors, such as age, cyst type, histologic findings and location, influence the prognosis of each patient. We present the case of a 29-year-old female patient who sought medical consultation due to colicky abdominal pain lasting one month, associated with persistent nausea and located in the upper right quadrant of the abdomen. Magnetic resonance imaging (MRI) revealed a Todani type Ia choledochal cyst. Therefore, she underwent a complete surgical excision, with a favorable postoperative course.
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