Icteric Baby with Abdominal mass

Friday, January 1, 2010
3 month old baby was admitted to the peaediatric ward by his parents because of their child was excessively crying over past 2 weeks.He was found to have Icteric and Right upper quandrial abdominal mass on examination.
Comment on this child Xray?



ANSWER - Type 1 Choledochal cyst

Choledochal cysts are rare. They are caused by a specific weakness in a part or the whole of the wall of the common bile duct, and usually presents in neonates or children.
Five types have been identified.The most common type is a fusiform dilatation of the common bile duct from which the gallbladder arises. Another variant is dilatation of the intraduodenal portion of the common duct.
CLINICAL PRESENTATION
Classical presentation of abdominal pain, jaundice and right upper quadrant mass occurs in about 33% of patients


Features of  acute cholangitis - fever, right upper quadrant tenderness, jaundice and leukocytosis
Biliary cirrhosis or diffuse peritonitis following rupture of the cyst

TREATMENT
Primary excision of the cyst and a Roux-en-Y choledochojejunostomy


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4 comments

  1. Anonymous Says:
  2. Can you make the picture larger,please ?

     
  3. xydau Says:
  4. This Is the Actual size of the Image.Im very sorry about the quality of that image!!!!!

     
  5. shameel Says:
  6. is it choledochal cyst?
    please post answers after a day or two.. otherwise the exercise is useless..

     
  7. xydau Says:
  8. Correct Answer for this is the Type 1 choledocal cyst which affects the main bile duct.

     

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