We’ll go onto a topic called
When you hear choledochal, it means
that now you’re in your biliary tree.
Not cholecystitis, you’re not
thinking about the gallbladder,
but this is literally in the biliary tree.
A choledochal cyst is not
a stone, by the way.
So this is not a choledocolithiasis.
This is a choledochal cyst,
a congenital issue in which there
is dilation of the biliary tree.
Your child is going to present
with the abdominal pain.
There is going to be jaundice, and
unfortunately, with this cyst,
there might be pancreatitis
With the choledochal cyst
in a child congenitally --
wow, you’re worried about malignancy.
Surgery is your next step of management.
Do not mess around.
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
Chronic cholangitis may cause
cirrhosis and require transplantation.
Remember, this is genetic, and anytime
that there is stasis of your bile,
now, what are you worried about?
Infection. It’s called cholangitis.
And in a young patient, my goodness,
that liver is so tender.
There’s every possibility that the child’s
liver might go rapidly into cirrhosis,
and your only step of management
here is liver transplantation.