Abstract
Congenital cystic dilatation of common bile duct is a rare condition in Africa and the West. Its discovery is often fortuitous. The diagnosis is based on imagery. Our goal was to report 3 cases followed by a literature review. Three patients were received, most often for pain of the right hypochondrium. There were 2 women and 1 man aged between 16 and 27 years old. The physical examination was normal. The abdominal CT scan allowed us to diagnose a IA Todani cyst in all patients, including one degenerate. Cholecystectomy with resection of the bile duct, followed by hepatico-jejunal anastomosis on anse-en-Y of Roux was performed in 2 patients. The immediate suites were simple. Histology showed inflammation on 2 operative specimen and cholangiocarcinoma on the 3rd. Choledochal DKC is a rare condition, often revealed in adults by complications. Bilio-pancreatic CT is an alternative to cholangio-MRI for its diagnosis with a type I Todani easily recognized. The treatment is surgical with a bad prognosis in case of degeneration.
Highlights
Congenital cystic dilatation (CCD) of bile ducts is due to an abnormality of the bilio- pancreatic junction, resulting from an embryological deficit of migration of the long common biliopancreatic junction and a sphincter deficiency [1, 2]
During surgical exploration we found a dilation compatible with a type Ia of Todani
The procedure consisted of cholecystectomy and resection of the common bile duct, followed by a Roux-en-Y hepatico- jejunal anastomosis
Summary
Congenital cystic dilatation (CCD) of bile ducts is due to an abnormality of the bilio- pancreatic junction, resulting from an embryological deficit of migration of the long common biliopancreatic junction and a sphincter deficiency [1, 2]. It is a rare pathology in Western countries and Africa, more frequent in Asia whose diagnosis is mainly based on imaging [3, 4]. The abdominal ultrasound was in favor of a mixed hilar formation, and intra-vesicular hyperechogenic formations without posterior acoustic shade. Abdominal CT-scan showed a bile duct cyst type Ia of Todani without intrahepatic extension with a tumoral intra luminal bud (Figures 1 and 2)
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