A changing pattern of presentation. Ann Surg 220: 644-652. [omicsonline.org]

Choledochocele presents at an older age, with the average age at presentation being 51 years. [jmedicalcasereports.biomedcentral.com]

A review of the literature has found only 6 reported cases.2,3 Around 80% present with symptoms before the age of 10. [elsevier.es]

Patients are usually adolescents and may present with a recurrent crisis of right upper quadrant pain, hyperamylasemia, or jaundice. Malignant transformation of a choledochocele occurs very rarely. [radiopaedia.org]

The presenting symptoms and coexisting diseases were shown in Table 1. [journals.lww.com]

• Pain

  Patients are usually adolescents and may present with a recurrent crisis of right upper quadrant pain, hyperamylasemia, or jaundice. Malignant transformation of a choledochocele occurs very rarely. [radiopaedia.org]

  Initially, she was given proton pump inhibitors, but her pain was not relieved. Further evaluation was done, and preoperative imaging showed a cyst in the second part of the duodenum. [jmedicalcasereports.biomedcentral.com]

  The classic triad of abdominal pain, right upper quadrant mass, and jaundice is more prevalent in the paediatric population and is reported to occur in 2%-38% of patients [4]. [eurorad.org]

  […] leak Chol. 32 5 22/M Abd. pain Type II Nil US/MRCP Excision Nil   7 6 37/M Abd. pain, Jn, and acute pancreatitis Type I-A Nil US/CT CC/CEx/HJ Nil   7 7 38/F Abd. pain, Jn, and abd. mass Type I-C Nil US/CT CC/CEx/HJ Nil Chol. 8 8 30/F Abd. pain Type I-A [hindawi.com]

• Asymptomatic

  Remaining asymptomatic, the lesion was left untreated. She has kept an uneventful course for 4 years ever since. [omicsonline.org]

  Intermittent jaundice and an abdominal mass are the most common findings in infants.9 Neonates are only rarely asymptomatic, as found in our case. [dovepress.com]

  The patient was asymptomatic, physical examination was unremarkable, and tumor markers showed no alterations. [revistagastroenterologiamexico.org]

  Autosomal Dominant Polycystic Kidney Disease with an Asymptomatic Type I Choledochal Cyst. Korean J Med. 2013;85(2):205-9. Law R, Topazian M. Diagnosis and treatment of choledochoceles. Clin Gastroenterol Hepatol. 2014;12(2):196-203. [ijmedicine.com]

  CCD may remain asymptomatic for many years and diagnosis may be made incidentally, when asymptomatic patients undergo imaging studies for unrelated process; however, these patients could present for the first time with complicated clinical presentation [hindawi.com]

• Inflammation

  Left untreated, this frequently lead to recurrent cholangitis (inflammation and infection in the bile ducts) or pancreatitis (inflammation of the pancreas). [surgery.ucsf.edu]

  Inflammation of the pancreas also may occur. The cause of these complications may be related to either abnormal flow of bile within the ducts or the presence of gallstones. [en.wikipedia.org]

  Abdominal ultrasound showed evidence of dilatation of the intra- and extrahepatic bile duct, a choledochal cyst and pancreas with inflammation. [elsevier.es]

  Conclusion Isolated dilatations of the cystic duct are extremely rare, and familiarity with this anatomic variation and its early diagnosis can prevent complications such as inflammation and malignancy and guide the surgery. [ejrnm.springeropen.com]

  Diagnosis relies on the exclusion of other conditions (e.g. tumor, gallstone, inflammation) as a cause of biliary duct dilatation. Choledochal cysts are rare, with an incidence of 1:100,000-150,000. [radiopaedia.org]

• Fever

  On the physical examination there was no sign of fever or jaundice. The abdomen was tender to deep palpation at the right upper quadrant. Neither rebound tenderness nor distention was noted. [eurorad.org]

  There was no history of sudden increase in the size of the abdominal lump or jaundice or fever with chills and rigors. The patient had mild dragging type of pain in the right upper abdomen with no specific aggravating or relieving factors. [panafrican-med-journal.com]

  There was no history of fever, jaundice, and weight loss. Physical examination revealed no abnormality except for tenderness in the RUQ. Hemogram and blood chemistry were normal. [ejrnm.springeropen.com]

  In adults, the most common findings are abdominal pain, fever, jaundice and vomiting. Abdominal pain is the most common symptom in adult patients, with an incidence ranging from 78% to 90%. [elsevier.es]

• Sepsis

  Apart from this, it requires sedation, and there are risks of complications such as biliary sepsis, cholangitis, pancreatitis, perforation, and contrast allergy. [ejrnm.springeropen.com]

  The current approach to CCD involves control of biliary sepsis and pancreatitis and defining both the superior and inferior extent of the cyst, before scheduling surgery in semielective setting [2–7]. [hindawi.com]

• Abdominal Pain

  The classic triad of intermittent abdominal pain, jaundice, and a right upper quadrant abdominal mass is found only in minority of patients. [en.wikipedia.org]

  The classic triad is abdominal pain, jaundice, and an abdominal mass but is present in a minority of infant patients (0%-17%). In adults, the most common findings are abdominal pain, fever, jaundice and vomiting. [elsevier.es]

  The classic triad of symptoms, which include abdominal pain, jaundice, and right upper quadrant mass, are usually present in pediatric patients [10, 11]. Adults are more likely to be asymptomatic or present only with abdominal pain [10]. [karger.com]

  The classic triad of abdominal pain, right upper quadrant mass, and jaundice is more prevalent in the paediatric population and is reported to occur in 2%-38% of patients [4]. [eurorad.org]

  Classical presentation includes the triad of 1: abdominal pain jaundice abdominal mass This triad is however only present in ~40% (range 19-60%) of cases, with palpable mass being the least common manifestation. [radiopaedia.org]

• Abdominal Mass

  Here we report a case of a 33-year-old lady who presented with a huge abdominal mass and on evaluation was found to have a giant choledochal cyst type 4A. [panafrican-med-journal.com]

  Classical presentation includes the triad of 1: abdominal pain jaundice abdominal mass This triad is however only present in ~40% (range 19-60%) of cases, with palpable mass being the least common manifestation. [radiopaedia.org]

  The most common findings in the infant group are jaundice, hepatomegaly, and an abdominal mass, but abdominal pain is not usually evident. [elsevier.es]

  The classic triad of intermittent abdominal pain, jaundice, and a right upper quadrant abdominal mass is found only in minority of patients. [en.wikipedia.org]

• Right Upper Quadrant Pain

  Patients are usually adolescents and may present with a recurrent crisis of right upper quadrant pain, hyperamylasemia, or jaundice. Malignant transformation of a choledochocele occurs very rarely. [radiopaedia.org]

  Case presentation A 34-year-old male patient was admitted to our hospital with right upper quadrant pain (RUQ) experienced intermittently for the past year, each episode of which had a duration of approximately 1 week. [ejrnm.springeropen.com]

  Case A 28-year-old woman, without a significant past medical history, was admitted for right upper quadrant pain. The physical examination was normal. The laboratory examinations showed elevated transaminases level. [link.springer.com]

  The classic presentation of choledochal cyst like right upper quadrant pain, jaundice and abdominal mass is rarely seen in adults. Large choledochal cysts can lead to complications if left untreated. [panafrican-med-journal.com]

• Vomiting

  She denied nausea, vomiting, or weight loss, and had a normal appetite. She had no other medical problems, took no medications regularly, and she had no previous surgical procedures. [elsevier.es]

  Infants under the age of 12 months may present with jaundice, acholic stools, and vomiting.[2] The most common presenting feature in adults is abdominal pain.[3][21] Evaluation No laboratory studies are specific for choledochal cysts. [statpearls.com]

• Nausea

  Jaundice, nausea, and cholangitis are found in 40%-50% of adults. Cholangitis or pancreatitis is a common symptom in adult. [elsevier.es]

• Jaundice

  Distension of the cyst would lead to colicky pain and stasis of bile in the lesion would result in obstructive jaundice, cholangitis, or cholelithiasis. [omicsonline.org]

  Patients are usually adolescents and may present with a recurrent crisis of right upper quadrant pain, hyperamylasemia, or jaundice. Malignant transformation of a choledochocele occurs very rarely. [radiopaedia.org]

  The classic triad of abdominal pain, right upper quadrant mass, and jaundice is more prevalent in the paediatric population and is reported to occur in 2%-38% of patients [4]. [eurorad.org]

  The patient presented an uneventful recovery and, 12 months after surgery, has had no new episodes of pancreatitis or jaundice. [elsevier.es]

• Hypertension

  If the obstruction is not relieved, permanent damage may occur to the liver - scarring and cirrhosis - with the signs of portal hypertension (obstruction to the flow of blood through the liver) and ascites (fluid accumulation in the abdomen). [en.wikipedia.org]

  The common late complications are cholangitis, obstructive jaundice, pancreatitis, stone formation, and portal hypertension [37]. [intechopen.com]

  Liver transplantation as an option is most suited for patients with diffuse intrahepatic form of the disease complicated by stones, recurrent cholangitis, fibrosis, cirrhosis, and portal hypertension. [hindawi.com]

  Though she had hypertension, type 2 diabetes mellitus, and post-hepatitic cirrhosis attributed to hepatitis C virus [HCV] she was presumed infected with through transfused blood, when she was hysterectomized for myoma uteri at her 5th decade, and suffered [omicsonline.org]

  Pregnancy was uneventful except for development of pregnancy-induced hypertension in labor. Prenatal laboratory findings were within normal limits. [dovepress.com]

Further workup with a multidisciplinary team led to the correct diagnosis and management. [jmedicalcasereports.biomedcentral.com]

Pre-transplant workup of these patients for occult cholangiocarcinoma is crucial.24 Minimally invasive resection of CC has gained popularity. [elsevier.es]

guidelines, discoveries in your fields of interest; be notified You are informed about innovative treatments, techniques and innovations in medicine Restriction This video is limited to doctors and other health professionals. [medtube.net]

Surgical Treatment Bile duct surgery with total cyst removal is the definitive treatment for choledochal cysts. [surgery.ucsf.edu]

Full Text A 77-year-old man had a past medical history of cancer of the prostate and colon for which he underwent prostatectomy and right hemicolectomy, respectively, 5 years before, with no coadjuvant treatment. [revistagastroenterologiamexico.org]

Endotherapy is the preferred treatment and first line in management. Failed endoscopic treatment necessitates surgery. [jmedicalcasereports.biomedcentral.com]

Treatment and outcomes of adults with remnant intrapancreatic choledochal cysts. Surgery 2016;159:418–25. Cited Here [12]. Kinoshita H, Hara M, Nishimura K, et al. [journals.lww.com]

Does the type of anomalous arrangement of pancreaticobiliary ducts influence the surgery and prognosis of choledochal cyst? J Pediatr Surg. 1992;27(6):728-31. Alonso-Lej F, Rever WB Jr, Pessagno DJ. [ijmedicine.com]

Treatment and prognosis Patients with type I, II, or IV cysts usually undergo surgical resection of the cyst due to the risk of malignancy. A number of possible approaches exist, depending on cyst location and other factors. [radiopaedia.org]

Hence early diagnosis and appropriate management are needed for the best prognosis. [statpearls.com]

[…] include cholecystitis, recurrent cholangitis, biliary stricture, choledocholithiasis, recurrent acute pancreatitis, and malignant transformation into cholangiocarcinoma.16,17 When occurring alone, the single umbilical artery has little effect on infant prognosis [dovepress.com]

Overall, CC resection has an excellent prognosis, with an 89% event-free rate and 5-year overall survival rates well over 90%.However, the risk of biliary malignancy remains elevated even more than 15 years after CC excision, and CC-associated biliary [elsevier.es]

Its precise etiology is not clear 3. Patients are usually adolescents and may present with a recurrent crisis of right upper quadrant pain, hyperamylasemia, or jaundice. Malignant transformation of a choledochocele occurs very rarely. [radiopaedia.org]

Its precise etiology is not clear. Patients are usually adolescents and may present with a recurrent crisis of right upper quadrant pain, hyperamylasemia, or jaundice. Malignant transformation of a choledochocele occurs very rarely. [devel.pacs.de]

The exact etiology is still unknown, although they predominantly affect females with a ratio of 4:1.1 According to the Todani classification, the distribution of the different types of choledochal cysts is: type I 50%–80%; type II 2%; type III 1.4%–4.5% [elsevier.es]

Dilatation of the intra and extrahepatic biliary tract, as well as the main pancreatic duct, was identified but its etiology could not be defined and so a biliary-pancreatic endoscopic ultrasound (EUS) study was performed. [revistagastroenterologiamexico.org]

Congenital choledochal cysts: new etiological concept based on anomalous relationships of the common bile duct and pancreatic bulb. Ann Radiol. 1969;12(3):231-40. Ladas SD, Katsogridakis I, Tassios P, Tastemiroglou T, Vrachliotis T, Raptis SA et al. [ijmedicine.com]

[…] curid=2309266 Epidemiology Although choledochal cysts are present at birth, they are increasingly diagnosed in adults and now comprise 20% of all new cases. Choledochal cysts are inflammatory in nature. [surgery.ucsf.edu]

Epidemiology, presentation, diagnosis, and outcomes of choledochal cysts in adults in an urban environment. Am J Surg, 189 (2005), pp. 527-531 [5] T. Kamisawa, H. Anjiki, N. Egawa, M. Kurata, G. Honda, K. Tsuruta. [elsevier.es]

Clinical-epidemiological analysis of a large consecutive series of malformed infants. Am J Med Genet A. 2008;146A(1):15–25. 5. Rittler M, Mazzitelli N, Fuksman R, de Rosa LG, Grandi C. [dovepress.com]

Caroli disease is associated with biliary atresia since it might share the same pathogenesis of ductal plate malformation, but is also associated with autosomal recessive polycystic kidney disease (PKD) and less frequently with autosomal dominant PKD.[9] Epidemiology [statpearls.com]

Surgery. 2004 Apr; [PubMed PMID: 15041974] [6] Okada A,Hasegawa T,Oguchi Y,Nakamura T, Recent advances in pathophysiology and surgical treatment of congenital dilatation of the bile duct. [statpearls.com]

The second theory known as Babbitt’s hypothesis is based on the pathophysiological consequence of reflux of activated proteolytic pancreatic enzymes on the biliary tract wall [18]. [hindawi.com]

Iwai NYanagihara JTokiwa KShimotake TNakamura K Congenital choledochal dilatation with emphasis on pathophysiology of the biliary tract. Ann Surg. 1992;21527- 30Google ScholarCrossref 13. [jamanetwork.com]

Conclusion Isolated dilatations of the cystic duct are extremely rare, and familiarity with this anatomic variation and its early diagnosis can prevent complications such as inflammation and malignancy and guide the surgery. [ejrnm.springeropen.com]

To prevent cyst recurrence, cancer of postoperative residual bile duct, and reoperation occurrence, the excision range is rational and appropriate but slightly radical. [journals.lww.com]

If they are dispersed, this procedure is not possible.19 The surgical treatment of bile duct cysts focuses on two main objectives: treat cyst-related complications and prevent or treat cyst-associated malignancy. [elsevier.es]

No studies have independently confirmed the efficacy of valved intestinal conduits in the prevention of reflux-induced cholangitis. Pericystic inflammation may prevent safe complete-cyst excision. [intechopen.com]

It is assumed that factors that could cause agenesis and regression of the umbilical vessel could also prevent or slow migration and/or multiplication of cells either: 1) by stopping tissue growth and development; or 2) by killing some cells already in [dovepress.com]