Choledochal cyst - type 4a

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Recurrent abdominal pain.

Patient Data

Age: 3 years
Gender: Male
mri

Cystic dilatation of the proximal and mid-common bile duct with calculi measuring approximately 4 and 2.5 mm in dependent parts of the dilated proximal/mid-common bile duct is observed.

The common hepatic duct, the confluence of hepatic ducts, proximal right and left main hepatic ducts, and cystic duct are also dilated.

The common bile duct measures approximately 15 mm in maximum diameter, the common hepatic duct 8 mm, the right main hepatic duct 6 mm, the left main hepatic duct 7 mm, and the cystic duct 6 mm.

Smooth tapering of the distal-most/terminal common bile duct is seen.

The gallbladder is distended with no obvious wall thickening or lesion. No obvious calculi are seen.

Case Discussion

Findings are suggestive of a choledochal cyst (type IVa) with choledocholithiasis.

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