Browse > Article

A Case of Choledochal Cyst Complicated by Liver Cirrhosis on Pathology in a 20-Month-Old-Girl  

Bae, Sun Hwan (Department of Pediatrics, School of Medicine, Konkuk University)
Choi, Sung Yun (Department of Pediatrics, School of Medicine, Eul-Ji University)
Lee, Tae Seok (Department of General Surgery, School of Medicine, Eul-Ji University)
Lee, Ho Jeong (Department of Pathology, School of Medicine, Eul-Ji University)
Publication Information
Clinical and Experimental Pediatrics / v.48, no.1, 2005 , pp. 104-107 More about this Journal
Abstract
Choledochal cyst is considered to be congenital anomalies of the biliary tract, characterized by varying degrees of cystic dilatation at various segments of the biliary tract. A 20-month-old girl was admitted to Eul-Ji general hospital because of abdominal distension. Physical examination revealed marked splenomegaly and hepatomegaly with nodular surface and hard consistency. Laboratory examination showed elevated transaminase level, alkaline phosphatase level and gamma glutamyltranspeptidase level without evidence of cholestasis. Diagnostic imaging study revealed choledochal cyst with Todani classification type 1. Cholecystectomy and Roux-en-Y choledochojejunostomy was performed, and wedge liver biopsy showed diffuse periportal fibrosis with cirrhotic change and ductular proliferation in the portal area. After operation, hepatosplenomegaly and abnormal laboratory examinations improved rapidly, and in 9 months, the liver and spleen became not palpable. We experienced a case of choledochal cyst complicated by liver cirrhosis on pathology in a 20 month-old girl, and removal of choledochal cyst improved clinical manifestations rapidly.
Keywords
Choledochal cyst; Liver cirrhosis; Child;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Balistreri WF, Bove KE, Ryckman FC. Biliary atresia and other disorders of the extrahepatic bile ducts. In : Suchy FJ. Sokol RJ, Balistreri WF, editors. Liver disease in children. 2nd ed. Philadelphia : Lippincott Williams & Wilkins, 2001: 253-74
2 Choledochal cyst in Korea : A survey by the Korean association of pediatric surgeons. J Korean Assoc Pediatr Surgery 2003;9:45-51
3 Davenport M, Howard ER. Surgical disorders of the liver and bile ducts. In : Kelly DA, editor. Diseases of the liver and biliary system in children. 1st ed. London : Blackwell Science, 1999:253-78
4 Varani S, Landini MP. Cytomegalovirus as a hepatotropic virus. Clin Lab 2002;48:39-44
5 de Vries JS, de vries S, Aronson DC, Bosman DK, Rauws EA, Bosma A, et al. Choledochal cyst : Age of presentation, symptoms, and late complications related to Todani's classification. J Pediatr Surg 2002;37:1568-73   DOI   ScienceOn
6 Jackson CC, Wu Y, Chenren S, Somme S, Chwals WJ, Liu DC. Bile decompression in children with histopathological evidence of pre-existing liver cirrhosis. Am Surg 2002;68: 816-9
7 Shiratori Y, Imazeki F, Moriyama M, Yano M, Arakawa Y, Yokosuka O, et al. Histologic improvement of fibrosis in patients with hepatitis C who have sustained response to interferon therapy. Ann Intern Med 2000;132:517-24
8 Song JB, Hwang KK, Cha CI, Kim KT. Two cases of idiopathic dilatation of the common bile duct. J Korean Pediatr Soc 1977;20:136-43
9 Lim SW. Choledochal cyst in children. J Korean Assoc Pediatr Surg 1999;5:121-5
10 Wanless IR, Nakashima E, Sherman M. Regression of human cirrhosis. Morphologic feature and the genesis of incomplete septal cirrhosis. Arch Pathol Lab Med 2000;124: 1599-607
11 Shin HS, Nam KJ, Lee JH, Kim CS, Choi JC, Oh JY. Spontaneous rupture of choledochal cyst : case report. J Korean Radiol Soc 2002;47:519-22
12 Lee SG, Kang YH, Han KC. Perforated choledochal cyst with bile peritonitis in an infant. J Korean Pediatr Soc 1982;25:854-8
13 Kim JH, Kim SJ, Kim KC, Cheong BY, Park WJ. A case of congenital choledochal cyst. J Korean Pediatr Soc 1981; 24:584-8
14 Lee JM, Sung IK, Kim JS, Oh CK. A case of choledochal cyst in a neonate. J Korean Pediatr Soc 1982;25:1068-72