5 years old female with epigastric pain and jaundice

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Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : hadi zolfeghari

Case Section

Abdominal Imaging

Patient's Information

Gender : Female
Age : 5

Clinical Summary

5 years old female with epigastric pain and jaundice

Imaging Findings

multiple focal dilatations of the main IHBDs with a large cystic dilatation of the CBD

Differential Diagnosis

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Final Diagnosis

Congenital Biliary Cysts (type IV)

Discussion (Related Text)

Choledochal cysts are uncommon congenital anomalies of the biliary tree characterized by cystic dilation of the bile ducts . Many (60%) present in infancy or childhood, while others present in adulthood. Some are discovered by fetal US. The condition is much more common in females (70% to 84% of cases). Patients present with abdominal pain, mass, and jaundice. The Todani classification (1977) is typically used to describe choledochal cysts . Type 1 lesions are most common (80% to 90%) and appear as fusiform or saccular dilatations of the CHD, CBD, or segments of each. Type 2 lesions are diverticula of the CBD attached by a narrow stalk. Type 3 lesions are termed choledochoceles and are focal dilatations of the intraduodenal portion of the CBD, closely resembling ureteroceles. Type IV lesions are defined as multiple focal dilatations of the IHBDs and EHBDs usually with a focal large cystic dilatation of the CBD. Type 5 lesions are referred to as Caroli disease, which is more properly classified as a disease separate from choledochal cyst.

References

1-Fundamentals of Diagnostic Radiology,Third Editio, EDITORS:WILLIAM E. BRANT,CLYDE A. HELMS 2-Lim JH. Oriental cholangiohepatitis: pathologic, clinical, and radiologic features. AJRAmJ RoentgenoI1991;157:1-8. 3-Levy AD, Rohrmann CA Jr, Murakata LA, Lonergan GJ. Caroli's disease: radiologic spectrum with pathologic correlation. AJR Am J RoentgenoI2002;179:1053-1057. 4- Kim OH, Chung HJ, Choi BG. Imaging of the choledochal cyst. Radiographics 1995;15:69-88.