Undiscribed intra and extrahepatic congenital choledochal cysts

Abstract

Background: Choledochal cysts are congenital anomalies involving cystic dilatation of bile ducts. They usually lead to obstruction of the bile ducts and retention of bile. If the obstruction is not relieved, permanent damage may occur to the liver. We report an undiscribed case of an intra and extrahepatic choledochal cystic dilatation. Methods: A 5 years old female girl was referred to our center from Syria with C/C of abdominal pain and jaundice of few months duration. She was left untreated for few months because she couldnt seak medical attention because she was living in a war zone area. Results: She was investigated and her blood tests revealed: serum bilirubin (total) 589 μmol/L, serum aspartate aminotransferase (AST) median 191.5 IU/L, gamma-glutamyl transferase 627.25 IU/L, alkaline phosphatase median 537 IU/L. MRCP revealed dilatation of the right, left, common hepatic, commone bile duct and cystic duct. Conclusion: Choledochal cysts are rare entities. The imaging modality of choice for diagnosing and characterizing choledochal cysts is MRCP. Our case has not been described before as it involves the intra and extra biliary system.