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Case of the Month

August 2005

Patient Data: Female 21 years

Clinical Info: The gynaecologist had found a cystic mass in the upper abdomen by accident during a routine ultrasound examination during pregnancy.

This image shows the cystic mass anterior of the portal vein.

There is normal flow in the portal vein and no flow within the lesion.

The partially contracted gallbladder lies anterior of the lesion.

The gallbladder has a communication with the cyst.

This image shows again the communication between the cyst and the gallbladder.

This image shows the relation between the cyst and the pancreas.

The intrahepatic bile ducts are not dilatated.

MRCP image of the same patient showing the cystic lesion.

This MRCP image also shows the relation of the cyst to the gallbladder. The cystic mass is a choledochal cyst. This is an uncommon lesion that is often asymptomatic as in this case. Because patients with a choledochal cyst have a higher risk in developing a bile duct carcinoma, these lesions are usually surgically treated although they are asymptomatic. The lesion must be differentiated from other cysts in the upper abdomen such as the large liver cyst shown on the images below.

Hepatic cyst and gallbladder anterior of the cyst.

CT scan of the same hepatic cyst.

For more images of choledochal cysts and other bile duct pathology see:

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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