Choledochal cyst with portal hypertension: A case report
نویسندگان
چکیده
Introduction: Choledochal cysts in adults are commonly associated with hepatobiliary pathology and complications of previous cyst related procedures. Portal hypertension is a rare complication of choledochal cyst. The treatment of choledochal cyst complicated by portal hypertension has evolved from internal drainage of cysts to single stage excision of cyst with bilioenteric anastomosis. Case Report: A 15yearold female presented with typical triad of abdominal pain, abdominal lump and jaundice. Magnetic resonance cholangiopan creatography (MRCP) was suggestive of typeI choledochal cyst with portal hypertension. An upper gastrointestinal endoscopy revealed grade 1 esophageal varices with proximal gastropathy. Intraoperatively, the posterior wall of the choledochal cyst was densely adherent to the portal vein and hence a partial excision of cyst with stripping of the mucosa of the posterior wall of the cyst along with RouxenY hepaticojejunostomy was done. Conclusion: Single stage excision of choledochal cyst with bilioenteric anastomosis is the treatment of choice of choledochal cyst with portal hypertension. Portal decompression is reserved for cases with extensive collaterals in the hepatoduodenal ligament.
منابع مشابه
Management of choledochal cyst with portal hypertension.
Portal hypertension (PHT) is a rare complication associated with choledochal cysts. Management issues of PHT patients are inadequately addressed, as its incidence is low and underlying causes variable. We report three cases of choledochal cyst with PHT. All patients had type IVa choledochal cysts, and the causes of PHT were secondary biliary cirrhosis (SBC) (two cases) and alcoholic liver disea...
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In the literature, CC presenting with PH has not been addressed adequately and there is a paucity of literature on CC complicated by PH. Gastrointestinal bleeding, splenomegaly or incidental discovery of esophageal varices led to the diagnosis of associated PH. Excision of CC and bilio-enteric bypass may not be feasible in those patients as there is a formation of massive collaterals in the reg...
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