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Case Report
 
Choledochal cyst with portal hypertension: A case report
Rahul Roy1, Jyoti Bansal1, Yeshwanth Rajagopal1, Rajendra mandia2, Raj Kamal Jenaw3
1Resident, General surgery, S M S Medical College, Jaipur, Rajasthan, India.
2Associate Professor, General surgery, S M S Medical College, Jaipur, Rajasthan, India.
3Professor, General surgery, S M S Medical College, Jaipur, Rajasthan, India.

doi:10.5348/ijcri-2012-12-231-CR-5

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Rahul Roy
Room No: 92, Resident Doctors Hostel
S M S Medical College, Jawahar Lal Nehru Marg
Jaipur, Rajasthan
India - 302004
Phone: 00917891463904
Email: rahul_dmch2002@yahoo.co.in

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How to cite this article:
Roy R, Bansal J, Rajagopal Y, Mandia R, Jenaw RK. Choledochal cyst with portal hypertension: A case report. International Journal of Case Reports and Images 2012;3(12):20–24.


Abstract
Introduction: Choledochal cysts in adults are commonly associated with hepatobiliary pathology and complications of previous cyst related procedures. Portal hypertension is a rare complication of choledochal cyst. The treatment of choledochal cyst complicated by portal hypertension has evolved from internal drainage of cysts to single stage excision of cyst with bilio-enteric anastomosis.
Case Report: A 15-year-old female presented with typical triad of abdominal pain, abdominal lump and jaundice. Magnetic resonance cholangiopan-creatography (MRCP) was suggestive of type-I choledochal cyst with portal hypertension. An upper gastrointestinal endoscopy revealed grade 1 esophageal varices with proximal gastropathy. Intraoperatively, the posterior wall of the choledochal cyst was densely adherent to the portal vein and hence a partial excision of cyst with stripping of the mucosa of the posterior wall of the cyst along with Roux-en-Y hepaticojejunostomy was done.
Conclusion: Single stage excision of choledochal cyst with bilio-enteric anastomosis is the treatment of choice of choledochal cyst with portal hypertension. Portal decompression is reserved for cases with extensive collaterals in the hepatoduodenal ligament.

Keywords: Complicated choledochal cyst, Portal hypertension


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Author Contributions
Rahul Roy – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Jyoti Bansal – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Yeshwanth Rajagopal – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Rajendra Mandia – Acquisition of data, Critical revision of the article, Final approval of the version to be published
Raj Kamal Jenaw – Acquisition of data, Critical revision of the article, Final approval of the version to be published
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Authors declare no conflict of interest.
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© Rahul Roy et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)