Choledochal Cysts (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
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.
In this Article
What are the symptoms and complications of choledochal cysts?
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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.
How are choledochal cysts diagnosed?
Choledochal cysts can be diagnosed in several ways. The most common is by ultrasonography.
The second most common way is by cholangiography, that is, the filling of the bile ducts with dye followed by x-ray imaging. The dye may be injected by a long needle directly into the bile ducts by advancing the needle through the skin and liver into the ducts or with an endoscopically-placed catheter from the duodenum through the Papilla of Vater (the point at which the bile duct enters the small intestine, also known as the Ampulla of Vater).
The most recent technique for identifying choledochal cysts is magnetic resonance imaging, also known as MRI. It offers the advantage of being non-invasive requiring neither an injection into the bile ducts or endoscopy.
Reviewed by Melissa Conrad Stöppler, MD on 7/19/2012
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