Abstract | INTRODUCTION: A choledochal cyst is a congenital malformation of the biliary tree which may remain asymptomatic and might manifest with atypical symptoms. We reported a missed cyst with a complicated presentation with imaging dilemmas and a satisfactory outcome of a tailored surgery. PRESENTATION OF CASE: An 18-year-old girl following cholecystectomy one and a half years ago, presented to us with post-cholecystectomy syndrome. MRI suggested a large cystic structure in the region of the gall bladder containing a stone within. However, it revealed a choledochal cyst during surgery with extreme periportal adhesions. Partial excision of the cyst and Roux-en-Y choledocho- jejunostomy were performed at their finest to combat perioperative complications. DISCUSSION: The diagnosis of a choledochal cyst is mostly based on imaging. But the imaging interpretation in a post-operative case is challenging. Total excision of the cyst in a complicated case might be impossible. Partial excision or cyst mucosectomy and cystoenterostomy are recommended in difficult cases. CONCLUSION: Any previous biliary surgery increases the risk of complications; therefore, specialized hepatobiliary support is required. And it is recommended to tailor the definite surgery in a complicated situation.
|
Authors | Md Sumon Rahman, Jesmin Rahman |
Journal | International journal of surgery case reports
(Int J Surg Case Rep)
Vol. 110
Pg. 108638
(Sep 2023)
ISSN: 2210-2612 [Print] Netherlands |
PMID | 37574631
(Publication Type: Case Reports)
|
Copyright | Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved. |