Type IV-A choledochal cyst with choledocholithiasis in an adult female: A case report.

Abstract

A choledochal cyst is a rare congenital anomaly of the biliary system, characterized by bile duct cystic dilatation, typically affecting the common bile duct. Choledochal cysts are generally categorized using the Todani classification system. The typical symptoms are jaundice, abdominal masses, and recurrent abdominal pain. As most cases are diagnosed in children, adult presentations are uncommon and often associated with complications. A 22-year-old female patient complained of severe abdominal pain and vomiting for 5 days, with signs of jaundice. Her abdominal ultrasound revealed fusiform dilation of the extrahepatic common bile duct with multiple calculi in its distal-most part. On CT cholangiogram of the abdomen, Type IV-A Choledochal cyst with non-obstructive choledocholithiasis was found. Although rare, choledochal cysts are a well-known clinical entity. It is essential to diagnose and treat patients because they may develop complications. Cholecystectomy combined with Roux-en-Y hepaticojejunostomy is the preferred treatment for Type IV-A choledochal cysts. Since choledochal cysts in adults are uncommon, early detection and treatment are essential to avoid serious complications. Ultrasonography (USG), Magnetic resonance cholangiopancreatography (MRCP), and Computed tomography (CT) can provide a diagnosis.