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


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.

  • Diagnosis is made with cholangiography showing a cystic collection of contrast material in communication with the bile duct.

  • Type II:

  • Type III:


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