GI - Choledochal Cyst

Question 1

Defintion

Answer 1

Congenital abnormalities that involves the dilation or enlargement of the bile duct

Question 2

Epidemiology

Answer 2

Females

Question 3

Aetiology

Answer 3

Unknown

Question 4

Pathophysiology

Answer 4

Developmental defect/abnormality in the process of developing normal bile ducts.

Question 5

Types

Answer 5

Type 1: Cystic dilation of the extrahepatic biliary duct (MC)
Type 2: Abnormal pouch or sac opening from the duct
Type 3: A cyst located within the duodenal wall
Type 4: Swellings of both the intrahepatic and extrahepatic biliary tracts
Type 5: Multiple intrahepatic cysts (LC)

Question 6

Symptoms

Answer 6

● JAUNDICE
● ACHOLIC (PALE) STOOLS
● Fever
● Palpable mass in RUQ
● Recurrent/persistent abdominal pain RUQ
● Pancreatitis
● Infection of bile ducts Cholangitis (Fever, RUQ pain, Jaundice)

Question 7

Diagnosis

Answer 7

FIRST LINE =
- FBC
- LFTs: bilirubin, ALP, GGT, AST, ALT
- Serum amylase and lipase
- U + E’s
GOLD STANDARD = Abdominal USS
Other = MRCP

Question 8

Differential diagnosis

Answer 8

Biliary atresia

Question 9

Treatment

Answer 9

Surgery - remove dilated segments
Regular surveillance after surgery