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CHOLEDOCHAL CYST

Men's Health, Women's Health / By

CHOLEDOCHAL CYST

Choledochal cysts are rare, congenital enlargement or dilation of the bile ducts.

  • The bile ducts are a series of slender ducts that carry digestive juices called bile from the liver to the gallbladder.
  • The bile ducts collect the bile from the liver (where it is made), drains it into the gallbladder and finally into the small intestine where it helps digest the fats in food.
  • The enlargement associated with this condition disrupts the bile from flowing well, which can result in liver problems.
    There are 5 main types of choledochal cyst depending on its location and the shape the cyst have.
  • Type 1, this is the most common and accounts for about 80-90% of all cases. This is the saccular (having the form of a sac) enlargement of a portion of or the entire common bile duct
  • In type 11, an isolated pouch (diverticulum) protrudes from the common bile duct
  • In type 111, the bottom end of the ducts, where the pancreatic ducts meet, dilates into the small intestine.
  • In type 1V, the bile ducts inside and outside of the liver enlarge or dilates.
  • In type V, the large ducts located inside the liver enlarges while the ducts outside the liver are normal. This type is referred to as Caroli disease.
  • Without treatment, the condition can lead to inflammation and infection in the bile ducts and inflammation of the pancreas.

CAUSES

The exact cause of the condition is unknown. Experts suggest that it may be due to the pancreas.

Normally, before the duct from the pancreas joins with the common bile ducts, it goes into the small intestine. This allows the muscle in the wall of the small intestine to keep the pancreas juices from flowing up into the bile duct. However, in some babies, the connection between the pancreas and the common bile ducts is higher up, so the muscle is unable to keep the pancreas juices out of the bile duct. Instead, they flow into the bile duct, damaging and weakening the wall of the duct as it forms.

SYMPTOMS

  • Severe abdominal pain in the upper right quadrant of the belly
  • Jaundice
  • Soft mass that can be felt in the upper right belly
  • Fever
  • Nausea and vomiting
  • Pale feces

DIAGNOSIS AND TREATMENT 

Prenatal ultrasound carried out before the baby is born.

A thorough examination of the child if the condition was not detected before birth but symptoms are present.

Blood test to check if the bile duct is infected or inflamed, and the liver function

Imaging tests such as ultrasound, abdominal MRI scan, abdominal CT scan to detect the cyst, location, and the shape.

Cholangiography where a dye is injected into the child and an X-ray scan is taken.

Hepatobiliary iminodiacetic acid scan (HIDA) which allow the doctor to see whether a special dye that collects in the liver can pass out from the liver to the bile duct.

TREATMENT

The best option of treatment is surgical excision of the cyst. The aim of surgery is to remove the cyst and create good bile flow from the liver to the small intestine.