00:01
We’ll go onto a topic called
choledochal cyst.
00:04
When you hear choledochal, it means
that now you’re in your biliary tree.
00:09
Not cholecystitis, you’re not
thinking about the gallbladder,
but this is literally in the biliary tree.
00:15
A choledochal cyst is not
a stone, by the way.
00:19
So this is not a choledocolithiasis.
This is a choledochal cyst,
a congenital issue in which there
is dilation of the biliary tree.
00:27
Your child is going to present
with the abdominal pain.
00:30
There is going to be jaundice, and
unfortunately, with this cyst,
there might be pancreatitis
taking place.
00:36
With the choledochal cyst
in a child congenitally --
wow, you’re worried about malignancy.
00:42
Surgery is your next step of management.
Do not mess around.
00:48
Under choledochal cyst, there’s
something called Caroli syndrome,
autosomal recessive condition. It’s a
saccular dilation of the intra-hepatic
bile duct. Whereas, when we talked
about choledochal cyst,
it could be intra or extra-hepatic.
If it’s intra-hepatic, you call this
Caroli syndrome.
01:06
Chronic cholangitis may cause
cirrhosis and require transplantation.
01:10
Remember, this is genetic, and anytime
that there is stasis of your bile,
now, what are you worried about?
Infection. It’s called cholangitis.
01:19
And in a young patient, my goodness,
that liver is so tender.
01:23
There’s every possibility that the child’s
liver might go rapidly into cirrhosis,
and your only step of management
here is liver transplantation.