Giant choledochal cyst presenting during third trimester of pregnancy

BMJ Case Rep. 2018 Jun 13:2018:bcr2018224891. doi: 10.1136/bcr-2018-224891.

Abstract

Biliary cystic disease is a rare entity. Twenty-five per cent of cases are diagnosed during adulthood and only a few reports have described this condition during pregnancy, where it represents a therapeutic challenge for both obstetricians and surgeons with regard to the risks it entails for the patient and the fetus.Definitive management is surgical resection, as cysts may progress to malignancy if untreated. During pregnancy, resection is generally deferred to after delivery, especially in the context of suspected cholangitis.A 19-year-old young woman with no previous prenatal control, presented to the emergency department on her 32nd week of gestation with abdominal pain and jaundice. A giant Todani I biliary cyst was observed on imaging along with dilation of the proximal biliary tree suggesting acute cholangitis. Fetal compromise prompted immediate delivery after which percutaneous biliary drainage was performed. Following recovery, the cyst was surgically resected.

Keywords: biliary intervention; gastrointestinal surgery; gastrointestinal system; surgery.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Cholangiopancreatography, Magnetic Resonance / methods
  • Choledochal Cyst / diagnostic imaging*
  • Choledochal Cyst / pathology
  • Choledochal Cyst / surgery*
  • Delivery, Obstetric / standards
  • Diagnosis, Differential
  • Drainage / instrumentation*
  • Drainage / methods
  • Female
  • Humans
  • Jaundice / diagnosis
  • Jaundice / etiology
  • Pregnancy
  • Pregnancy Trimester, Third*
  • Rare Diseases
  • Treatment Outcome
  • Young Adult