Diagnostic dilemma in a large choledochal cyst

  • Tul Maya Gurung kathmandu university
  • Rabin Koirala
  • Amit Shrestha


Choledochal cysts are rare congenital anomalies that have a variable presentation with occasional diagnostic and therapeutic dilemmas.
Our case is a 14-year female presented with recurrent abdomen pain with confusing diagnostic findings, suggestive of a large choledochal cyst (22X29X17cm) initially managed by percutaneous tube biliary drainage and later underwent excision and HPE revealing non-malignant findings.
The choledochal cyst should always be a differential diagnosis for any patient presenting with an abdominal mass and should be managed accordingly.


1. Lu B, Shen Z, Yu J, Yang J, Tang H, Ma H. Laparoscopic surgery for removal of choledochal cysts and Roux-en-Y anastomosis. Int J Clin Exp Med. 2015 Aug 15;8(8):13013-6.
2. Lira A. K., Soto A. J., Frigerio P., Choledochal cyst todani IA case report. Int J Surg Case Rep. 2016;28:293-295.
3. Singham J, Yoshida E. M., Scudamore C. H. Choledochal cysts: part 1 of 3: classification and pathogenesis. Can J Surg. 2009 Oct;52(5):434-40.
4. Alt?ntoprak F, Yener Uzuno?lu M, Dikicier E, Zengin ?. Choledochal cysts- Classification, physiopathology, and clinical course. Integrative Cancer Science and Therapeutics. 2016;3(5).
5. Babbitt DP. Congenital choledochal cysts: new etiological concept based on anomalous relationships of the common bile duct and pancreatic bulb. Ann Radiol (Paris). 1969;12(3):231-40.
6. Liu CL, Fan ST, Lo CM, Lam CM, Poon RT, Wong J. Choledochal cysts in adults. Arch Surg. 2002 Apr;137(4):465-8.
7. Metcalfe MS, Wemyss-Holden SA, Maddern GJ. Management dilemmas with choledochal cysts. Arch Surg. 2003 Mar;138(3):333-9.
8. Tareq AS, Hanan R, Sameer S. Adult choledochal cyst: a case report, JRMS, 2006 Jun;13(1):64-6.
9. Weyant MJ1, Maluccio MA, Bertagnolli MM, Daly JM. Choledochal cysts in adults: a report of two cases and review of the literature. Am J Gastroenterol. 1998 Dec;93(12):2580-3.
10. O'Neill JA Jr. Choledochal cyst. Curr Probl Surg. 1992 Jun;29(6):361-410.
How to Cite
GURUNG, Tul Maya; KOIRALA, Rabin; SHRESTHA, Amit. Diagnostic dilemma in a large choledochal cyst. J Soc Surg Nep, [S.l.], v. 22, n. 2, p. 39-40, jan. 2020. ISSN 2392-4772. Available at: <http://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=363>. Date accessed: 27 oct. 2020.