González SJR, Manzur CD, Girón MJ, Carballo L, Reyes PC, Estévez CI

Language: Spanish
References: 15
Page: 161-164
PDF size: 177.65 Kb.

ABSTRACT

Objective. Description of a case of choledochal cyst handled in Hospital Rafael Pascasio Gamboa in Tuxtla Gutiérrez, Chiapas. See. Juarez hospital of Mexico. S.S.A. Description of the case. Feminine of 29 years of age with antecedent of colic pain in superior left quadrant without irradiations of 2 years of evolution, increases with the ingestion of cholecistokinetics accompanied by jaundice, nause and vomit, and cholecistectomy 2 previous months. At urgency room she presents pain without jaundice and Murphy, without peritoneal irritation. Total bilirubin .41, direct bilirubin .12, indirect bilirubin .28, alkaline fosfatasa 62 USG, fusiform expansion of choledochal in third middle of 64 x 37mm with presence of litho in its interior without expansion of the intrahepatic biliary system. TAC: cystic image in choledochal with dimensions of 54 x 56 mm CPE fusiform dilation of choledochal proximal of 5 x 6 cm Qx. Choledochal Cyst Todani 1 type. We made resection of the same and hepaticojejunoanastomosis. Conclusions. The choledochal cyst is diagnosed in its majority in the childhood and single adolescence and only 20 to 30% of the cases is in the adult life. The triad found even up to 14% is: jaundice, cholestasis and pain. The excision of the cyst with some technique of derivation is the ideal treatment, other treatments depend on the morphologic type of the cyst, transduodenal sphincteroplasty or endoscopic papillotomy has been used for choledochoceles and transplant for Caroli’s disease.

REFERENCES

1. O’Neill J. Choledochal Cyst. Curr Probl Surg 1992; 29: 363-410.

2. Alonzo-Lej F, Revor W, Pessagno D. Congenital choledochal cyst, with a report of two, and an analysis of 94 cases. Surg Gynecol Obstet Int Abstr Surg 1959; 108: 1-30.

3. Chaudhary A, Dhar P, Sachdev A, et al. Choledochal cysts- differences in children and adults. Br J Surg 1996; 83: 186-8.

4. Fassler S, Martínez J, Gutiérrez O. Enfermedades de la vesícula y las vías biliares. En: Chalem F, Escandón J, Campos J, et al. Medicina Interna, 3a. ed, Santafé de Bogotá, Fundación Instituto de Reumatología e Inmunología; 1997; p. 1164-5.

5. Tan K, Howard E. Choledochal cyst: a 14-year surgical experience with 36 patients. Br J Surg 1988; 75(9): 892-5.

6. Serrano M, García E, Contreras J. Síndrome de Caroli. Rev Colomb Cir 1993; 8(3): 203-6.

7. Florent CH, Florent M. Flourie B. Les kistes du choledoque. Med Chir Dig 1986; 15: 405-8.

8. Lilly J. Surgery of coexisting biliary malformation in choledochal cyst. J Pediatr Surg 1979; 14: 643-7.

9. Caro A. César Roux y su Famosa Y. Rev Colomb Cir 1992; 7(3): 166-8.

10. Cosentino C, Luck S, Raaffensperger J, et al. Choledochal duct cyst: Resection with physiologic reconstruction. Surgery 1992; 112(4): 740-8.

11. Vacanti J, Sano K. Surgical treatment of jaundice in newborn infants. In: Nyhus L, Baker R, Fischer J, editors. Mastery of Surgery. 3th ed. USA: Little Brown and Company; 1997; p. 1159-67.

12. Karnak I, Cahit F, Büyükpamukçu N, et al. Spontaneous rupture of choledochal cyst: An unusual cause of acute abdomen in children. J Pediatr Surg 1997; 32(5): 736-8.

13. Yamataka A, Ohshiro K, Okada Y, et al. Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pediatr Surg 1997; 32(7): 1097-102.

14. Alvarado García R, Reza Villa A. Quiste gigante de colédoco, informe de un caso. Cir Ciruj 2002; 70: 40-3.

15. Fernández Rivero JM, Sánchez Moreno R. Quiste de colédoco, imagen radiológica y transoperatoria. Rev Gastroenterol 2003; 68(4): 296.