ABSTRACT

Choledochal cyst presentation has been classified as infantile and adult forms. Infants typically present with obstructive jaundice, with or without acholic stool, due to inflammation and bile stasis. Choledochal cyst may be detected by prenatal ultrasound as early as 15 weeks' gestation. It should be differentiated from other cystic lesions within the area such as duodenal atresia, ovarian cyst, duplication cyst and, most important, cystic variants of biliary atresia. Postnatal scans of progressive enlargement of the cyst or dilatation of intrahepatic ducts are indicative of a choledochal cyst rather than biliary atresia. Occasionally, large choledochal cysts with inflammation may depict soft tissue density on plain radiography displacing the surrounding intestines to the left. A dilated long common channel is often associated with choledochal cyst and complicated by acute or chronic pancreatitis from protein plugs and calculi. Pancreaticobiliary malunion without cystic biliary dilatation has been termed a 'forme fruste' type of choledochal cyst.