総胆管嚢胞
- 関
- choledochal cyst、common bile duct cyst
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/03/09 15:55:39」(JST)
[Wiki en表示]
| Choledochal cysts |
| Classification and external resources |
Different types of choledochal cysts |
| ICD-10 |
Q44.4 |
| ICD-9 |
751.69 |
| DiseasesDB |
2527 |
| eMedicine |
article/172099 article/366004 article/934267 |
| MeSH |
D015529 |
Choledochal cysts 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.
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Contents
- 1 Signs and symptoms
- 2 Diagnosis
- 3 Treatment
- 4 References
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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 or Caroli's disease: Cystic dilatation of intra hepatic biliary ducts.
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.
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.
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Health science - Medicine - Cystic diseases
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| Respiratory system |
- Langerhans cell histiocytosis
- Lymphangiomyomatosis
- Cystic bronchiectasis
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| Skin |
- stratified squamous: follicular infundibulum
- Epidermoid cyst/Proliferating epidermoid cyst
- Milia
- Eruptive vellus hair cyst
- outer root sheath
- Trichilemmal cyst/Pilar cyst/Proliferating trichilemmal cyst/Malignant trichilemmal cyst
- sebacious duct
- Steatocystoma multiplex/Steatocystoma simplex
- Keratocyst
- nonstratified squamous: Cutaneous ciliated cyst
- Hidrocystoma
- no epithelium: Pseudocyst of the auricle
- Mucocele
- other/ungrouped: Cutaneous columnar cyst
- Keratin implantation cyst
- Verrucous cyst
- Adenoid cystic carcinoma
- Breast cyst
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| Musculoskeletal system |
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| Digestive system |
- oral cavity: Cysts of the jaws
- Odontogenic cyst
- Radicular 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 syndrome
- 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
- Persistent cloaca
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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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UpToDate Contents
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English Journal
- A botryoid rhabdomyosarcoma diagnosed as a choledochal cyst.
- Margain-Deslandes L, Gelas T, Bergeron C, Pracros JP, Collardeau-Frachon S, Lachaux A, Mure PY.SourcePediatric Surgery Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Claude Bernard University, Lyon, France.
- Pediatric blood & cancer.Pediatr Blood Cancer.2013 Dec;60(12):2089-90. doi: 10.1002/pbc.24680. Epub 2013 Jul 5.
- PMID 23832499
- A New Operative Approach for Type I Choledochal Cysts.
- Jin LX, Fields RC, Hawkins WG, Linehan DC, Strasberg SM.SourceWashington University in Saint Louis School of Medicine, St. Louis, MO, USA.
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract.J Gastrointest Surg.2013 Nov 13. [Epub ahead of print]
- To present a novel modification of the surgical technique for open excision of type I choledochal cysts. The treatment of choice for choledochal cyst is surgical excision because such cysts are associated with an increased incidence of cancer. The commonly used operative technique provides poor acce
- PMID 24222324
- Early experience of laparoscopic choledochal cyst excision in children.
- Lee JH, Kim SH, Kim HY, Choi YH, Jung SE, Park KW.SourceDepartment of Pediatric Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Journal of the Korean Surgical Society.J Korean Surg Soc.2013 Nov;85(5):225-229. Epub 2013 Oct 25.
- PURPOSE: Laparoscopic choledochal cyst excision with Roux-en-Y hepaticojejunostomy (LCE) in children is being attempted more frequently around the world, and although it has been performed in Korea, no publication has been published on it. However, cholangitis and/or pancreatitis are limitations tha
- PMID 24266013
Japanese Journal
- 急性胆管炎を契機に診断されたcholedochoceleの1例
- 乾山 光子,岸本 有為,岡野 直樹,原 精一,宅間 健介,三村 享彦,伊藤 謙,塩沢 一恵,渡邉 学,大久保 陽一郎,渋谷 和俊,三上 哲夫,五十嵐 良典
- Progress of Digestive Endoscopy 84(1), 192-193, 2014
- … A diagnosis of choledochocele was made. … The major duodenal papilla could not be identified on the EGD because of the ballooned choledochocele filled with contrast medium. … A needle knife precut was made, and the choledochocele subsequently collapsed after the CBD stones were removed. …
- NAID 130004985512
- 嚢腫状に拡張した下部胆管に認められた十二指腸乳頭部癌の1例
- 藤田 祐司,渡邉 誠太郎,佐藤 高光,加藤 真吾,細野 邦広,小林 規俊,遠藤 格,山中 正二,窪田 賢輔
- 胆道 27(2), 240-246, 2013
- … 認めた．胆管深部挿管は困難でありsuprapapillary incisionを施行した．ERCで胆管末端の嚢腫状拡張を認めた．EUS，IDUSでは胆管末端は12 mm径の嚢腫状の拡張を認め，十二指腸乳頭部に腫瘍の筋層侵潤を認めた．乳頭部生検は腺癌であった．術前画像診断でAbから発生した浸潤癌と診断した．非共通管拡張型のCholedochoceleの合併も示唆された．手術施行されたが開腹時，肝臓に微小結節が多発していたため試験開腹のみとなった． …
- NAID 130004545482
- 胆管癌を合併した choledochocele の1例
- 福庭 暢彦,大廻 あゆみ,宮崎 慎一
- 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 52(2), 272-273, 2010-02-20
- NAID 10026909683
Related Links
- Choledochocele symptoms, causes, diagnosis, and treatment information for Choledochocele (Bile duct cysts) with alternative diagnoses, full-text book chapters, misdiagnosis, research treatments, prevention, and prognosis. ...
- A choledochocoele refers to a specific type of choledochal cyst (type III under the Todani classification system). In this type there is dilatation of the intramural portion of the distal common bile duct within the duodenal wall. Its precise ...
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総胆管嚢胞
- 関
- choledochal cyst、choledochocele