Choledochal Cyst

Choledochal cyst is the most common variety of congenital cyst of the extrahepatic biliary duct. There are three major varieties in this group-

1. Cystic dilatation involving the entire common bile duct and common hepatic duct with cystic duct entering the choledochal cyst.
2. Diffuse dilatation of the common bile duct.
3. A small cystic duct dilatation of the distal common bile duct.

Symptoms-
1. It occurs four times more frequently in females.
2. Only one third of cases are diagnosed in the first decade of life and only half the cases present before the age of 20 years.
3. The cyst may contain as much as 1 to 2 liters of bile and the cyst wall shows inflammatory changes with absence of lining epithelium.
4. Upper abdominal pain.
5. Obstructive jaundice.
6. Fever.
7. Pain and jaundice are frequently intermittent but gradually severe.
8. Palpable epigastric mass.

Investigations-
1. Intravenous cholangiography.
2. Ultrasound.
3. Transhepatic cholangiography.
4. Magnetic Resonance Cholangiopancreatography.

Treatment-
Early operation is the treatment of choice.
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