Abstract
Introduction:
Ruptured choledochal cyst is an unusual problem in children that has a variety of therapeutic approaches reported through case series in the literature. 1 –3 Laparoscopic excision of the cyst is now commonly performed when no signs of perforation are present. Here we present a case of effective laparoscopic excision of a ruptured choleochal cyst after a course of antibiotics and percutaneous drainage by interventional radiology.
Methods:
A 2-year-old female presented with a 5-day history of abdominal pain. A CT scan showed ascites and a choledochal cyst. The patient underwent percutaneous drainage of bilious ascites and magnetic resonance cholangiopancreatography was obtained and further confirmed the diagnosis of ruptured placement of a transhepatic biliary drainage catheter by interventional radiology. Six weeks later, she underwent effective laparoscopic excision of the ruptured cyst.
Results:
The operation was completed with a laparoscopic approach by removing the cyst and performing a hepaticoduodenostomy. The perforation was in the posterior wall of the cyst and significant inflammation required mucosectomy of that wall. The patient recovered without complication.
Conclusion:
Percutaneous drainage and laparoscopic excision of a ruptured choledochal cyst present a safe option for the management of this unusual and often complicated problem.
No competing financial interests exist.
Runtime of video: 4 mins 16 secs
