Saudi Journal of Gastroenterology

IMAGE QUIZ
Year
: 2012  |  Volume : 18  |  Issue : 3  |  Page : 223--224

Dilated biliary system


Sudipta Saha, Vivek Gautam, Manoj Andley, Ashok Kumar, Ajay Kumar 
 Department of Surgery, Lady Hardinge Medical College, Delhi, India

Correspondence Address:
Sudipta Saha
Department of Surgery, F-514, Block F, Pragati Vihar Hostel, Lodhi Road, Delhi - 110 003
India




How to cite this article:
Saha S, Gautam V, Andley M, Kumar A, Kumar A. Dilated biliary system.Saudi J Gastroenterol 2012;18:223-224


How to cite this URL:
Saha S, Gautam V, Andley M, Kumar A, Kumar A. Dilated biliary system. Saudi J Gastroenterol [serial online] 2012 [cited 2021 Oct 19 ];18:223-224
Available from: https://www.saudijgastro.com/text.asp?2012/18/3/223/96469


Full Text

A 32-year-old woman presented with complaints of intermittent dull aching pain at the right upper abdomen for the last 3 months. There was no radiation of pain and the pain was not related to meals. There was no history of jaundice. Abdominal examination was normal. Ultrasonography showed cystic dilatation of common hepatic and common bile duct. Following this magnetic resonance cholangio-pancreatography (MRCP) [Figure 1] and contrast-enhanced computed tomography [Figure 2] of the abdomen was done.{Figure 1}{Figure 2}

 Questions





Q1. What is the diagnosis?

Q2. What is the treatment?

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 Answers





Type-IA choledochal cyst with cholalgocarcinoma. [1] MRCP shows dilatation of the common bile duct (CBD) with mass in its lower end. Contrast-enhanced computed tomography shows the mass to be anteriorly placed in the lower CBD. Biliary tract malignancy has been reported to occur in 2.5-28% of patients with choledochal cyst, representing a risk at least 20 times greater than that of the normal population. [2] Pancreaticoduodenectomy with excision of whole cyst. Complete removal of distal extrahepatic cholangiocarcinoma usually requires a pancreaticoduodenectomy (Whipple procedure). Curative resections are associated with a 25-50% 5-year survival rate. The main determinants of poor outcomes are positive surgical margins and lymph node involvement. [3]

References

1Singham J, Yoshida EM, Scudamore CH. Choledochal cysts: Part 1 of 3: Classification and pathogenesis. Can J Surg 2009;52:434-40.
2Liu CL, Fan ST, Lo CM, Lam CM, Poon RT, Wong J. Choledochal cysts in adults. Arch Surg 2002;137:465-8.
3Aljiffry M, Walsh MJ, Molinari M. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009. World J Gastroenterol 2009;15:4240-62.