Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Bile that is produced in the liver flows through
increasingly larger channels (ducts) within the liver and finally into even
larger ducts that leave the liver, pass through the substance of the pancreas, and then empty into the
duodenum.
A choledochal
cyst is a cyst (hollow outpouching) of the bile ducts. Choledochal cysts have
been classified into several different types depending on where they are located
and whether they can be seen as separate structures from the ducts
(diverticulum-like); or whether they can be seen as a localized dilation
(enlargement) of the ducts. Choledochal cysts are rare, occurring in
less than 1% of individuals. The cause of choledochal cysts is unknown, but they
are congenital, that is, present from birth, and, therefore, represent
developmental abnormalities of the bile ducts in the fetus.
What are the symptoms and complications of choledochal cysts?
In infants, choledochal cysts usually lead to obstruction
of the bile ducts and retention of bile. This leads to jaundice and an enlarged
liver. If the obstruction is not relieved, permanent damage may occur to the
liver - scarring and cirrhosis - with the signs of portal hypertension
(obstruction to the flow of
blood through the liver) and ascites (fluid
accumulation in the abdomen). There is an increased risk of cancer in the wall of the cyst.
In older individuals, choledochal cysts are more likely
to cause abdominal pain and intermittent episodes of jaundice and occasionally cholangitis
(inflammation within the bile ducts caused by the spread of bacteria from the
intestine into the bile ducts). Pancreatitis also may occur. The cause of these
complications may be related to either abnormal flow of bile within the ducts or
the presence of gallstones.
Gallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large as a golf ball. There can be just one large stone, hundreds of tiny stones, or any combination. The majority of gallstones do not cause symptoms.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Pancreatitis is a rare disease in which the pancreas becomes inflamed, occurring when digestive enzymes are activated and begin attacking the pancreas causing damage to the gland. There are two types of pancreatitis, acute and chronic. Most commonly caused by alcohol or gallstones, it can lead to bleeding in the gland, serious tissue damage, infection, and cysts. Enzymes and toxins may then enter the bloodstream and seriously injure organs, such as the heart, lungs, and kidney.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
Portal hypertension is most commonly caused by cirrhosis, a disease in which results from scarring of a liver injury. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from teh liver to the heart, and a parasitic infection called schistosomiasis.
Birth defects have many causes and currently, are the leading cause of death for infants in the first year of life. Some of the causes of birth defects include genetic or chromosome problems. Exposure of the mother to rubella or German measles during pregnancy, or using drugs or alcohol during pregnancy. The treatment for birth defects depends upon the condition of the effected child.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
An MRI (or magnetic resonance imaging) scan is a
radiology technique that uses magnetism, radio waves, and a computer
to produce images of body structures. The MRI scanner is a tube
surrounded by a giant circular magnet. The patient is placed on
a moveable bed that is inserted into the magnet. The magnet creates
a strong magnetic field that aligns the protons of hydrogen atoms,
which are then exposed to a beam of radio waves. This spins the
various protons of the body, and they produce a faint signal
that is detected by the receiver portion of the MRI scanner.
The receiver information is processed by a computer, and an image
is produced.
The image and resolution produced by MRI is quite detailed and can
detect tiny changes of structures within the body. For some procedures, contrast agents, such as gadolinium, are used to increase the accuracy of the images.
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