Cyst

2022 - 10 - 1

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Image courtesy of "Cureus"

Choledochal Cyst in Pregnancy: A Case Report (Cureus)

Choledochal cyst is a rare congenital malformation of the biliary tree. It can be present in various locations along the biliary tree.

[[8]](#references). [[5]](#references). Excision of the extrahepatic cyst with drainage of the intrahepatic cyst part with wide hilar or subhilar anastomosis has shown satisfactory results in type IVA patients [[15]](#references). [[6]](#references) and gallbladder function changes caused by pregnancy. However, in type IVA like our patient, the presence of intrahepatic cysts accounts for a number of long-term complications such as hepatolithiasis with recurrent cholangitis, secondary biliary cirrhosis with portal hypertension, and malignant transformation [[15]](#references). Surgical treatment options include decompression with Roux-nY, which showed improvement in 60%-70% of patients; another surgical option is excision with hepaticojejunostomy, which is considered the treatment of choice nowadays for stable non-pregnant patients [[15]](#references). [1](#figure-anchor-452047)). As she showed improvement clinically and in bloodwork tests (Table [[1]](#references). Abdominal computed tomography (CT) showed multiple cystic intrahepatic and large extrahepatic ducts that were dilated and communicating with the biliary tree. The patient underwent emergency lower segment cesarean section (LSCS) due to preterm labor and fetal distress, with no intra- or postoperative complications. The diagnosis of a choledochal cyst during pregnancy can be challenging for clinicians due to its atypical presentation, limitations of radiographic modalities, and hormonal effects on the biliary system [[4]](#references).

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A Giant Choledochal Cyst Mimicking Pancreatic Pseudocyst: A Case ... (Cureus)

A choledochal cyst (CC) is a rare congenital anomaly manifested as cystic dilatation of the biliary tree. A giant choledochal cyst is defined as a cyst with ...

[[1, 2,5]](#references). [[1,5]](#references). Also, to the best of our knowledge, this is the first case reported of giant CC complicated with both infection and pancreatitis. The surgical treatment depends on Todani classification and includes complete cyst excision (including gallbladder) with biliary-enteric anastomosis if the common bile duct is affected [[1]](#references). Most of the giant CCs are of type IVA and type I, according to Todani’s classification. Type II CC is very rare (2-3%) and appears as an extrahepatic, supraduodenal diverticulum [[2]](#references). We proceeded with cholecystectomy and the complete resection of the diverticulum after its dissection. We describe the case of giant, infected CC presenting as acute pancreatitis and misdiagnosed as a pancreatic pseudocyst. A choledochal cyst (CC) is a rare congenital anomaly manifested as cystic dilatation of the biliary tree. On physical examination, he was febrile (temperature of 38.5 °Celsius), had tachycardia, and had tenderness in the epigastric and right upper quadrant. A giant choledochal cyst is defined as a cyst with a maximum diameter of ≥ 10 cm.

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