2023SAGE Open Medical Case ReportsOpen access

Choledochal cyst mimicking as choledocholithiasis: A case report and review of literature

Ameer Mustafa Farrukh, Hershey R Bhagat, Mohamed Burhan Ismail, Maharshikumar P Sandesara, M. Assal, Rutendo Denise Makonyonga

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Abstract

Choledochal cysts are rare congenital anomalies of the biliary system, mostly diagnosed during childhood. In adults, a lower incidence and symptom overlap with more common biliary conditions may hinder the diagnosis. This case study presents a 50-year-old female patient who presented with abdominal pain and multiple gallstones on ultrasonography which also showed a dilation of the common bile duct, presumably left by a stone that had already passed. However, the dilation still existed 3 days later, which raised suspicion of a choledochal cyst. Magnetic resonance cholangiopancreatography was performed, and following surgical consultation, the patient underwent a successful cyst excision by Roux-en-Y hepaticojejunostomy with a smooth recovery leading to hospital discharge. This case highlights the importance of considering choledochal cysts as one possible diagnosis in adults with biliary symptoms and the significance of the more specific imaging modalities such as magnetic resonance cholangiopancreatography.

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What this paper is about

Choledochal cysts are rare congenital anomalies of the biliary system, mostly diagnosed during childhood. In adults, a lower incidence and symptom overlap with more common biliary conditions may hinder the diagnosis. This case study presents a 50-year-old female patient who presented with abdominal pain and multiple gallstones on ultrasonography which also showed a dilation of the common bile duct, presumably left by a stone that had already passed. However, the dilation still existed 3 days later, which raised suspicion of a choledochal cyst. Magnetic resonance cholangiopancreatography was performed, and following surgical consultation, the patient underwent a successful cyst excision by Roux-en-Y hepaticojejunostomy with a smooth recovery leading to hospital discharge. This case highlights the importance of considering choledochal cysts as one possible diagnosis in adults with biliary symptoms and the significance of the more specific imaging modalities such as magnetic resonance cholangiopancreatography.

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Available abstract

Choledochal cysts are rare congenital anomalies of the biliary system, mostly diagnosed during childhood. In adults, a lower incidence and symptom overlap with more common biliary conditions may hinder the diagnosis. This case study presents a 50-year-old female patient who presented with abdominal pain and multiple gallstones on ultrasonography which also showed a dilation of the common bile duct, presumably left by a stone that had already passed. However, the dilation still existed 3 days later, which raised suspicion of a choledochal cyst. Magnetic resonance cholangiopancreatography was performed, and following surgical consultation, the patient underwent a successful cyst excision by Roux-en-Y hepaticojejunostomy with a smooth recovery leading to hospital discharge. This case highlights the importance of considering choledochal cysts as one possible diagnosis in adults with biliary symptoms and the significance of the more specific imaging modalities such as magnetic resonance cholangiopancreatography.

Key concepts: Choledochal cysts, Medicine, Magnetic resonance cholangiopancreatography, Magnetic resonance imaging, Gallstones, Radiology, Abdominal pain, Common bile duct

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