- Choledochal Cyst Center
- Take the Tummy Trouble Quiz
- Boost Digestive Health
- Digestive Distress Slideshow: Problem Foods to Avoid
- Patient Comments: Choledochal Cysts - Experience
- Patient Comments: Choledochal Cysts - Symptoms
- Find a local Gastroenterologist in your town
What is a choledochal cyst?
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. 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.
Quick GuideDigestive Disorders: Common Misconceptions
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 of the bile ducts, also known as MRCP. It offers the advantage of being non-invasive requiring neither an injection into the bile ducts or endoscopy.
How are choledochal cysts treated?
The best way of treating choledochal cysts is to surgically remove them and reconstruct the bile ducts that were affected. The cyst should be completely removed whenever possible. If the ducts cannot be reconstructed, they should be sewn to the intestine so that bile can drain freely out of the ducts.
Daily Health News
Digestive Disorders Resources
Subscribe to MedicineNet's General Health Newsletter
REFERENCE: MedscapeReference.com. Choledochal cysts.
Top Choledochal Cysts Related Articles
Birth DefectsBirth 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 HealthChildren'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.
CirrhosisCirrhosis 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,
- body fluid accumulation, and
- frequent infections.
Duodenal Biliary DrainageDuodenal biliary drainage is a procedure used to help diagnose gallstones. A duodenal biliary drainage procedure is fairly risk free and painless.
GallstonesGallstones 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 signs or symptoms; however, when they do occur the primary sign is biliary colic. Symptoms of biliary colic are constant pain for 15 minutes to 4-5 hours, and it may vary in intensity; nausea, severe pain that does not worsen with movement; and pain beneath the sternum. Treatment of gallstones depends upon the patient and the clinical situation.
Jaundice in Adults
Jaundice (hyperbilirubinemia) in adults may be caused by a variety of medical diseases or conditions. Some cases of jaundice can be managed at home with a doctor's supervision, while other causes of jaundice may be life-threatening. Symptoms of jaundice are:
- Yellow skin
- Yellowing of the whites of the eyes
- Pale colored stools
- Dark urine
- Itchy skin
- Rectal bleeding
Treatment of jaundice is focused on the disease or condition that is causing jaundice.
MRI ScanMRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Pancreatitis is a rare disease in which the pancreas becomes inflamed. There are two types of pancreatitis: acute and chronic. Symptoms of pancreatitis include abdominal pain, fever, nausea, vomiting, and a rapid pulse. Treatment of pancreatitis often requires hospitalization.
Portal HypertensionPortal 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 the liver to the heart, and
- a parasitic infection called schistosomiasis.
- varices (enlarged veins),
- vomiting blood and blood in the stool.
- black, tarry stool,
- ascites (abnormal fluid collection within the peritoneum, the sac that contains the intestines within the abdominal cavity),
- confusion and lethargy,
- splenomegaly or enlargement of the spleen, and
- decreased white blood cell counts.
UltrasoundUltrasound (and ultrasonography) is imaging of the body used in the medical diagnosis and screening of diseases and conditions such as:
- heart valve irregularities,
- carotid artery disease,
- heart disease,
- kidney stones,
- liver disease,
- diseases of the female reproductive, and
- diseases of the male reproductive organs.