Journal of Scientific and Technical Research (Sharda University, Noida)

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Imaging Diagnosis of a Giant Abdominal Cyst in an Infant


Affiliations
1 Department of Radiology, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, India
2 Department of Pediatric Surgery, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh, India
3 Department of Pathology, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh, India
     

   Subscribe/Renew Journal


The usual etiologies of giant abdominal cystic masses in infants are mesenteric cyst, enteric duplication cyst, ovarian cyst in females, cystic lymphangioma, and the presentation of a choledochal cyst in a gigantic form is however, unusual. The primary modality for diagnosis of this entity is ultrasound, followed by MRI. The characteristic ultrasound features of a choledochal cyst are a well-defined cystic lesion which may be replacing any segment of biliary tree and is distinctly separate from the gallbladder. The associated anomalies are biliary atresia, gallbladder atresia, hepatic fibrosis and also anomalies of the pancreatico-biliary system. MRI with MRCP has a conclusive role in confirming the ultrasound diagnosis. Choledochal cysts are classified based on Todani et al.’s method as comprising of five types. Herein we report the case study of a 4 month old male infant afflicted with a gigantic Type 1 Choledochal cyst, which was diagnosed by us at the first instance itself by ultrasound examination and was corroborated by MRI. The diagnosis was further confirmed at surgery and histopathology. The recommended treatment of resection of the cyst accompanied by a hepatico-jejunostomy by pass procedure, was successfully performed in the reported infant.

Keywords

Choledochal Cyst, Giant Abdominal Cyst, Infant, MRI, Ultrasound Features.
User
Subscription Login to verify subscription
Notifications
Font Size

  • D. E. Light, F. R. Pianki, and E. H. Ey, "abdominal mass in an infant,” Journal of American Osteopathic College of Radiology, vol. 4, no. 25, 2015.

  • L. Ferrero, R. Guana, G. Carbonaro, M. G. Cortese, L. Lonati, E. Teruzzi, and J. Schleef, "Crystic infra-abdominal,asses in Children, "Cystic infra-abdominal masses in children, "Pediatric Reports. Vol.9, no.3, p. 7284, 2017, doi: 10.4081/pr.2017.7284. PMID: 29081933; PMCID: PMC5643949.

  • J. H. Yoon, "Magnetic resonance cholangiopancreatography diagnosis of choledochal cyst involving the cystic duct: Report of three cases,” The British Journal of Radiology, vol. 84, pp. e18-e22, 2011.

  • M. Kumar, and S. Rajagopalan, “Choledochal cyst,” Medical Journal Armed Forces India, vol. 68, no. 3, pp. 296-298, 2012, doi: 10.1016/j.mjafi.2012.04.011.

  • K. C. Soares, D. J. Arnaoutakis, I. Kamel, N. Rastegar, R. Anders, S. Maithel et al., “Choledochal cysts: Presentation, clinical differentiation, and management,” J American College of Surgeons, vol. 219, no. 6, pp. 1167-1180, 2014, doi: 10.1016/j.jamcollsurg.2014.04.023.

  • M. A. Moslim, H. Takahashi, F. G. Seifarth, R. M. Walsh, and G. Morrisstiff, “Choledochal cyst disease in a western center: A 30-year experience,” Journal of Gastrointestinal Surgery, vol. 20, no. 8, pp. 1453-1463, 2016, doi: 10.1007/s11605-016-3181-4.

  • J. S. Banks, G. Saigal, J. M. D’Alonzo, M. D. Bastos, and N. V. Nguyen, “Choledochal malformations: Surgical implications of radiologic findings,” American Journal of Roentgenology, vol. 210, no. 4, pp. 748-760, 2018, doi: 10.2214/ajr.17.18402.

  • N. A. Ndoye, B. WelléI, L. Cissé, D. Guèye, C. Diouf, P. A. Mbaye et al., “Choledochalcyst in children in Dakar: Diagnostic and therapeutic aspects,” African Journal of Paediatric Surgery, vol. 18, pp. 168-170, 2021.

  • A. K. Dhua, V. Bhatnagar, D. Kandasamy, A. Mitra, A. Ranjan, and A. Varshney, “Giant choledochal cyst in infancy - A rare entity,” Tropical Gastroenterology, vol. 36, no. 4, pp. 282-283, 2015.

  • J. M. Suleiman, D. Msuya, R. Philemon, A. Sadiq, P. Amsi, and J. Lodhia, “A giant choledochal cyst: A case reported from Tanzania,” International Journal of Surgery Case Reports, vol. 81, 2021, Art. no. 105829, doi: 10.1016/j.ijscr.2021.105829.

  • G. Papaioannou, and J. McHugh, “Investigation of an abdominal mass in childhood,” The British Institute of Radiology, vol. 16, no. 2, pp. 114-123, 2004, doi:10.1259/imaging/11980186.

  • S. Ono, S. Fumino, S. Shimadera, and N. Iwai, “Long-term outcomes after hepaticojejunostomy for choledochal cyst: A 10- to 27-year follow-up,” Journal of Pediatric Surgery, vol. 45, no. 2, pp. 376-378, 2010.

  • O. H. Kim, H. J. Chung, and B. G. Choi, “Imaging of the choledochal cyst,” Radiographics, vol. 15, no. 1, pp. 69-88, 1995.

  • J. S. Banks, G. Saigal, J. M. D’Alonzo, M. D. Bastos, and N. V. Nguyen, “Choledochal malformations: Surgical implications of radiologic findings,” AJR Am J Roentgenol., vol. 210, no. 4, pp. 748-760, 2018.


Abstract Views: 126

PDF Views: 0




  • Imaging Diagnosis of a Giant Abdominal Cyst in an Infant

Abstract Views: 126  |  PDF Views: 0

Authors

Shabnam Bhandari Grover
Department of Radiology, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, India
Sonali Malhotra
Department of Radiology, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, India
Saurabh Pandey
Department of Radiology, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, India
Ravi Kale
Department of Pediatric Surgery, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh, India
Anshu Gupta
Department of Pathology, School of Medical Sciences and Research, Sharda Hospital, Sharda University, Greater Noida, Uttar Pradesh, India

Abstract


The usual etiologies of giant abdominal cystic masses in infants are mesenteric cyst, enteric duplication cyst, ovarian cyst in females, cystic lymphangioma, and the presentation of a choledochal cyst in a gigantic form is however, unusual. The primary modality for diagnosis of this entity is ultrasound, followed by MRI. The characteristic ultrasound features of a choledochal cyst are a well-defined cystic lesion which may be replacing any segment of biliary tree and is distinctly separate from the gallbladder. The associated anomalies are biliary atresia, gallbladder atresia, hepatic fibrosis and also anomalies of the pancreatico-biliary system. MRI with MRCP has a conclusive role in confirming the ultrasound diagnosis. Choledochal cysts are classified based on Todani et al.’s method as comprising of five types. Herein we report the case study of a 4 month old male infant afflicted with a gigantic Type 1 Choledochal cyst, which was diagnosed by us at the first instance itself by ultrasound examination and was corroborated by MRI. The diagnosis was further confirmed at surgery and histopathology. The recommended treatment of resection of the cyst accompanied by a hepatico-jejunostomy by pass procedure, was successfully performed in the reported infant.

Keywords


Choledochal Cyst, Giant Abdominal Cyst, Infant, MRI, Ultrasound Features.

References