Choledochal Cysts

by Carlo Raj, MD

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    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.

    About the Lecture

    The lecture Choledochal Cysts by Carlo Raj, MD is from the course Pancreatic and Biliary Tract Diseases: Basic Principles with Carlo Raj.

    Included Quiz Questions

    1. Choledochal cyst
    2. Choledocholithiasis
    3. Gallstone pancreatitis
    4. Gallstone ileus
    5. Biliary dyskinesia
    1. "The cysts are congenital in origin."
    2. "The cysts are formed due to infections."
    3. "The cysts are formed after surgical treatment."
    4. "The cysts are formed due to parasitic infestation."
    5. "The cysts are formed due to a tumor-like change."
    1. Saccular dilatations of the intrahepatic duct
    2. Compression of the common bile duct by the distended gallbladder
    3. Hepatic vein thrombosis
    4. Migratory thrombophlebitis
    5. Hepatic artery thrombosis

    Author of lecture Choledochal Cysts

     Carlo Raj, MD

    Carlo Raj, MD

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