PDF(Pubmed)
Abstract：
Choledochal cyst is a congenital pathology with an uncommon anomaly associated with common complaints of an abdominal lump and hepatic dysfunction. It may be presented equally in any phase of life, be it childhood, adolescence, or adulthood, and is majorly detected by ultrasonography (USG) on the appearance of primary symptoms in the hepato-biliary system. It has a classical triad consisting of a lump in the upper quadrant on the right side of the abdomen, pain in the upper part of the abdomen, and obstructive jaundice. A few of the clinical features overlap with sickle cell disease. A 30-year-old male patient with sickle cell anemia was diagnosed eight years ago. The patient was diagnosed with a choledochal cyst with the clinical presentation of abdominal pain, nausea, and vomiting, which hampered his routine life. Due to symptomatic recurrence, the patient was subjected to USG (abdomen), which showed a dilated common bile duct (CBD) and dilated intrahepatic biliary radicals. This is a rare case presentation with both sickle cell disease and choledochal cyst, which are symptomatically similar. Based on history, risk factor analysis, and diagnostic findings, the patient was advised to have a Roux-en-Y hepatico-jejunostomy. Endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP) are the investigations of choice, with the better being MRCP. ERCP is a therapeutic and diagnostic modality that helps in the removal of CBD calculus and the placement of a stent. There may be increased bilirubin, showing features of obstructive jaundice in alcoholic stools. In surgical management, which is of total excision of the cyst, there are vital structures in proximity. The patients with these complaints need to be evaluated thoroughly, and detailed clinical examination and proper radiological investigations will be performed. Roux-en-Y hepatico-jejunostomy with cyst excision in toto is the procedure of choice.
摘要：
胆总管囊肿是一种先天性病理，具有罕见的异常，与腹部肿块和肝功能障碍的常见病有关。它可以在生命的任何阶段平等地呈现，无论是童年，青春期,或者成年期，并且主要通过超声检查（USG）发现肝胆系统的主要症状。它有一个经典的三合会，由腹部右侧上象限的肿块组成，腹部上部疼痛，和梗阻性黄疸.一些临床特征与镰状细胞病重叠。8年前，一名30岁的男性镰状细胞性贫血患者被诊断出。患者被诊断为胆总管囊肿，临床表现为腹痛，恶心,呕吐,这阻碍了他的日常生活。由于症状复发，患者接受了USG（腹部），显示胆总管扩张（CBD）和肝内胆管自由基扩张。这是一个罕见的病例，有镰状细胞病和胆总管囊肿，它们的症状相似。基于历史,风险因素分析，和诊断结果，建议患者进行Roux-en-Y肝空肠吻合术.内镜逆行胰胆管造影术（ERCP）和磁共振胰胆管造影术（MRCP）是首选的研究。最好是MRCP。ERCP是一种治疗和诊断方式，有助于去除CBD结石和放置支架。可能有胆红素升高,在酒精粪便中表现出阻塞性黄疸的特征。在外科管理中，这是囊肿的完全切除，附近有重要的结构。有这些投诉的患者需要彻底评估，并将进行详细的临床检查和适当的放射学检查。Roux-en-Y肝空肠吻合术与囊肿切除是首选方法。
