Choledochal Cysts

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.