GI Radiology > Biliary > Bile Ducts > Congenital > Choledochal Cysts

Congenital

Choledochal Cysts

  1. Pathogenesis:
  • There are five types of choledochal cysts. The fifth type, known as Caroli's disease, will be discussed on the following page.
  • Choledochal cysts are the most common congenital bile duct anomaly and are often associated with other gallbladder anomalies, biliary stenosis, or atresia, and congenital hepatis fibrosis.
     
  • 60% present before the age of 10.
     
  • Appear more often in females (3:1).
     
  • Symptoms include obstructive jaundice in the neonate and right upper quadrant pain with intermittent jaundice and fever in older children and adults.
     
  • Possible complications include the following:
     
    • Rupture with secondary bile peritonitis.
       
    • Cholangitis.
       
    • Cirrhosis and portal hypertension.
       
    • Calculus formation.
       
    • Portal vein thrombosis.
       
    • Liver abscess.
       
    • Hemorrhage.
       
    • Malignant transformation.
       
  • Treatment involves surgical resection.
     
  1. Radiographic findings:
  • Type I
     
  • US and CT: a cystic fluid-filled structure that communicates with the biliary system is visualized inferior to the porta hepatis.
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  • Diagnosis is made with cholangiography showing a cystic collection of contrast material in communication with the bile duct.

  • Type II:

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  • Type III:
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