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Image of the Month—Diagnosis
Arch Surg. 2007;142(10):1008.
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Answer: Choledochal Cyst, Todani Type I—Diagnosis
Bile duct cysts (BDCs) are rare (1 in 1300 to 1 in 2 million live births), constituting less than 1% of benign biliary diseases.1-2 Typically, affected children exhibit intermittent jaundice along with a palpable and painful abdominal mass. Twenty percent of patients are adults with right upper abdominal discomfort.3 Surgery is performed in an effort to reduce short- and long-term cyst-associated complications such as cholecystitis, cholangitis, pancreatitis, intrahepatic abscesses or liver cirrhosis, portal hypertension, and malignant changes, all of which occur more frequently in adults.4 In our patient, the cyst was completely resected, followed by classic Roux-en-Y anastomosis to the common hepatic duct. Noninvasive diagnostic imaging includes ultrasonography, computed tomography, or magnetic resonance cholangiopancreatography, with endoscopic retrograde cholangiopancreatography as an invasive option. The new standard criterion seems to be magnetic resonance cholangiopancreatography because its sensitivity is similar to that of endoscopic retrograde cholangiopancreatography and it is associated with less risk . . . [Full Text of this Article]
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Image of the Month—Quiz Case
Vanessa Banz, Karl Mahler, Thomas Treumann, and Juerg Metzger
Arch Surg. 2007;142(10):1007.
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