WordNet
- a closed sac that develops abnormally in some body structure
PrepTutorEJDIC
- 胞嚢(ほうのう)
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/09 09:15:56」(JST)
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Not to be confused with Colloid cyst.
| Choledochal cysts |
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Different types of choledochal cysts
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| Classification and external resources |
| ICD-10 |
Q44.4 |
| ICD-9 |
751.69 |
| DiseasesDB |
2527 |
| eMedicine |
article/172099 article/366004 article/934267 |
| MeSH |
D015529 |
Choledochal cysts (aka bile duct cyst) are congenital conditions involving cystic dilatation of bile ducts.[1] They are uncommon in western countries[2] but not as rare in East Asian nations like Japan and China.
Contents
- 1 Signs and symptoms
- 2 Diagnosis
- 3 Treatment
- 4 References
- 5 External links
Signs and symptoms
Most of them present in 1st year of life; adult presentation is rare and usually at this stage is associated with complication . Classic triad of intermittent abdominal pain, jaundice, and a right upper quadrant abdominal mass is found only in minority of patients.
Diagnosis
Direct Hyperbilirubinemia
Types
They were classified into 5 types by Todani in 1977.[3]
Classification was based on site of the cyst or dilatation. Type I to IV has been subtyped.
- Type I: Most common variety (80-90%) involving saccular or fusiform dilatation of a portion or entire common bile duct (CBD) with normal intrahepatic duct.
- Type II: Isolated diverticulum protruding from the CBD.
- Type III or Choledochocele: Arise from dilatation of duodenal portion of CBD or where pancreatic duct meets.
- Type IVa: Characterized by multiple dilatations of the intrahepatic and extrahepatic biliary tree.
- Type IVb: Multiple dilatations involving only the extrahepatic bile ducts.
- Type V: Cystic dilatation of intra hepatic biliary ducts. Not the same etiology as Caroli's disease.
- Type VI: An isolated cyst of the cystic duct is an extremely rare lesion. Only single case reports are documented in the literature. The most accepted classification system of biliary cysts, the Todani classification, does not include this lesion. Cholecystectomy with cystic duct ligation near the common bile duct is curative.[4]
Treatment
Choledochal cysts are treated by surgical excision of the cyst with the formation of a roux-en-Y anastomosis to the biliary duct. Future complications include cholangitis and a 2% risk of malignancy, which may develop in any part of the biliary tree. A recent article published in Journal of Surgery suggested that choledochal cysts could also be treated with single-incision laparoscopic hepaticojejunostomy with comparable results and less scarring. In cases of saccular type of cyst, excission and placement of T shaped tube is done.
Currently, there is no accepted indication for fetal intervention in the management of prenatally suspected choledochal cysts.[5]
Reference: Single-incision versus conventional laparoscopic cyst excision and Roux-Y hepaticojejunostomy for children with choledochal cysts: a case-control study.Diao M, Li L, Li Q, Ye M, Cheng W.World J Surg. 2013 Jul;37(7):1707-13. doi: 10.1007/s00268-013-2012-y.PMID 23539195 [PubMed - in process]
References
- ^ "choledochal cyst" at Dorland's Medical Dictionary
- ^ Liu YB, Wang JW, Devkota KR et al. (2007). "Congenital choledochal cysts in adults: twenty-five-year experience". Chin. Med. J. 120 (16): 1404–7. PMID 17825168.
- ^ Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K (1977). "Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst". Am. J. Surg. 134 (2): 263–9. doi:10.1016/0002-9610(77)90359-2. PMID 889044.
- ^ http://link.springer.com/article/10.1007%2Fs00595-008-3789-4#page-1
- ^ Coran AG, et al., eds. Pediatric Surgery. 7th ed. Philadelphia: Elsevier Saunders; 2012. Gonzales KD, Lee H. Chapter 106: Choledochal Cyst [Prenatal Diagnosis].
External links
- The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery - Resection of a Type I Choledochal Cyst Video
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Cystic diseases
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| Respiratory system |
- Langerhans cell histiocytosis
- Lymphangioleiomyomatosis
- Cystic bronchiectasis
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| Skin |
- stratified squamous: follicular infundibulum
- Epidermoid cyst and Proliferating epidermoid cyst
- Milia
- Eruptive vellus hair cyst
- outer root sheath
- Trichilemmal cyst and Pilar cyst and Proliferating trichilemmal cyst and Malignant trichilemmal cyst
- sebaceous duct
- Steatocystoma multiplex and Steatocystoma simplex
- Keratocyst
- nonstratified squamous: Cutaneous ciliated cyst
- Hidrocystoma
- no epithelium: Pseudocyst of the auricle
- Mucocele
- other and ungrouped: Cutaneous columnar cyst
- Keratin implantation cyst
- Verrucous cyst
- Adenoid cystic carcinoma
- Breast cyst
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| Human musculoskeletal system |
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| Human digestive system |
- oral cavity: Cysts of the jaws
- Odontogenic cyst
- Periapical cyst
- Dentigerous cyst
- Odontogenic keratocyst
- Nasopalatine duct cyst
- liver: Polycystic liver disease
- Congenital hepatic fibrosis
- Peliosis hepatis
- bile duct: Biliary hamartomas
- Caroli disease
- Choledochal cysts
- Bile duct hamartoma
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| Nervous system |
- Cystic leukoencephalopathy
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| Genitourinary system |
- Polycystic kidney disease
- Autosomal dominant polycystic kidney
- Autosomal recessive polycystic kidney
- Medullary cystic kidney disease
- Congenital cystic dysplasia
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| Other conditions |
- Hydatid cyst
- Von Hippel–Lindau disease
- Tuberous sclerosis
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Congenital malformations and deformations of digestive system (Q35–Q45, 749–751)
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| Upper GI tract |
| Tongue, mouth and pharynx |
- Cleft lip and palate
- Van der Woude syndrome
- tongue
- Ankyloglossia
- Macroglossia
- Hypoglossia
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| Esophagus |
- EA/TEF
- Esophageal atresia: types A, B, C, and D
- Tracheoesophageal fistula: types B, C, D and E
- esophageal rings
- Esophageal web (upper)
- Schatzki ring (lower)
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| Stomach |
- Pyloric stenosis
- Hiatus hernia
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| Lower GI tract |
| Intestines |
- Intestinal atresia
- Meckel's diverticulum
- Hirschsprung's disease
- Intestinal malrotation
- Dolichocolon
- Enteric duplication cyst
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| Rectum/anal canal |
- Imperforate anus
- Vestibular fistula
- Persistent cloaca
- Rectal atresia
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| Accessory |
| Pancreas |
- Annular pancreas
- Accessory pancreas
- Johanson–Blizzard syndrome
- Pancreas divisum
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| Bile duct |
- Choledochal cysts
- Biliary atresia
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| Liver |
- Alagille syndrome
- Polycystic liver disease
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Index of the mouth
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| Description |
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| Disease |
- Congenital
- face and neck
- cleft
- digestive system
- Neoplasms and cancer
- Other
- Symptoms and signs
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| Treatment |
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Index of digestion
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| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Congenital
- Neoplasms and cancer
- Inflammatory bowel disease
- Gluten sensitivity
- Other
- Symptoms and signs
- Blood tests
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| Treatment |
- Procedures
- Drugs
- anabolic steroids
- antacids
- diarrhoea and infection
- bile and liver
- functional gastrointestinal disorders
- laxatives
- peptic ulcer and reflux
- nausea and vomiting
- other
- Surgery
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UpToDate Contents
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English Journal
- Hepatorenal fibrocystic diseases in children.
- Park E1, Lee JM, Ahn YH, Kang HG, Ha II, Lee JH, Park YS, Kim NK, Park WY, Cheong HI.
- Pediatric nephrology (Berlin, Germany).Pediatr Nephrol.2015 Aug 11. [Epub ahead of print]
- BACKGROUND: Hepatorenal fibrocystic diseases (HRFCDs) are a group of monogenic disorders characterized by developmental abnormalities involving the liver and kidney. In this study, we performed genotype and phenotype analyses of children with HRFCDs to determine the distribution of underlying diseas
- PMID 26260382
- Recurrent Pancreatitis in a Patient With Choledochal Cyst and Anomalous Pancreaticobiliary Junction.
- Nusrat S1, Maple JT1.
- The American journal of gastroenterology.Am J Gastroenterol.2015 Aug;110(8):1141. doi: 10.1038/ajg.2014.428.
- PMID 26263355
- Signet-ring cell carcinoma coexisting with adenocarcinoma arising in a choledochal cyst: report of a case.
- Hua R1, Zhang JF, Liu W, Huo YM, Sun YW.
- Surgery today.Surg Today.2015 Aug;45(8):1049-52. doi: 10.1007/s00595-014-1049-3. Epub 2014 Oct 29.
- Signet-ring cell carcinoma (SRCC) is rare in the biliary system. We report a case of SRCC coexisting with adenocarcinoma, arising in a choledochal cyst of the extrahepatic bile duct. The patient was a 52-year-old man, hospitalized for the investigation of jaundice and pruritus. Abdominal computed to
- PMID 25352010
Japanese Journal
- Endoscopic biliary drainage for children with persistent or exacerbated symptoms of choledochal cysts
- TSUCHIYA Hironori,KANEKO Kenitiro,ITOH Akihiro,KAWASHIMA Hiroki,ONO Yasuyuki,TAINAKA Takahisa,MURASE Naruhiko,ANDO Hisami
- Journal of hepato-biliary-pancreatic sciences 20(3), 303-306, 2013-03-01
- NAID 10031168224
- Laparoscopic surgery for choledochal cysts (Recent advances in pediatric hepatobiliary surgery)
- Liem Nguyen Thanh
- Journal of hepato-biliary-pancreatic sciences : official journal of the Japanese Society of Hepato-Biliary-Pancreatic Surgery, the Asian-Pacific Hepato-Pancreato-Biliary Association, the Japan Biliary Association 20(5), 487-491, 2013
- NAID 40019673526
Related Links
- Type III (choledochocele): Therapeutic choice depends on the size of the cyst; choledochoceles measuring 3 cm or less can be treated effectively with endoscopic sphincterotomy, whereas lesions larger than 3 cm (which ...
- Choledochal cysts represent congenital cystic dilatations of the biliary tree. Diagnosis relies on the exclusion of other conditions (e.g. tumour, gallstone, inflammation) as a cause of biliary duct dilatation.EpidemiologyCholedochal ...
Related Pictures
★リンクテーブル★
[★]
- 英
- choledochal cyst
- →先天性胆道拡張症
- 関
- 総胆管嚢胞、胆管嚢胞、胆管嚢腫
[show details]
[★]
総胆管嚢胞
- 関
- choledochal cyst、common bile duct cyst
[★]
総胆管嚢胞
- 関
- choledochal cyst、choledochocele
[★]
- 関
- choledochus、common bile duct