ABSTRACT
La pancreatitis aguda es una complicación evolutiva de los quistes de colédoco, se asocia a alteraciones de la unión biliopancreática y litiasis intra-quística. Se describe un caso de pancreatitis y obstrucción de vía biliar por quiste de colédoco tipo IVa complicado por cálculos enclavados, en infante de 2 años...
Acute pancreatitis is a known complication of choledochal cysts. It is associated with changes in the biliopancreatic junction and with intra-cystic gallstones. We describe a case of pancreatitis and biliary obstruction caused by choledochal cyst type Iva complicated with obstruction by biliary stones in a 2 year old infant...
Subject(s)
Humans , Male , Child, Preschool , Lithiasis , Pancreatitis , Choledochal CystABSTRACT
The authors report a case of spontaneous perforation of the biliary tract (S.P.B.T) in a three-month-old infant. The diagnosis was suspected before the operation by clinical signs and diagnostic tests. The importance of paracentesis and scintigraphy is stressed. A surgical approach was chosen and drainage procedure of the area around the perforation and a cholecystostomy were done. S.P.B.T. is rare and its etiology is controversial, but cannot be forgotten in association between biliary ascites and cholestatic jaundice during the first months of life.
ABSTRACT
Pancreatic duct stones are commonly associated with recurrent pancreatitis. They are believed to develop as a result of the calcification of an intraductal protein plug. A choledochal cyst is a relatively rare anomaly usually presenting with abdominal pain, jaundice and palpable mass. APBDU (anomalous pancreaticobiliary ductal union) is frequently associated with various pancreatobiliary diseases, including choledochal cyst, biliary tumor, pancreatitis and pancreas divisum. We report a 48-year-old woman who presented with right upper quadrant pain with a pancreatic duct stone, a choledochal cyst and APBDU. She underwent endoscopic pancreatic sphincterotomy, a surgical choledochal cyst excision and Roux-en-Y choledochojejunostomy.
Subject(s)
Female , Humans , CystsABSTRACT
OBJETIVO: Relatar a experiência no diagnóstico e tratamento do cisto de colédoco no Hospital Municipal Jesus em cinco anos (1996-2001) e a experiência brasileira publicada para o tratamento do cisto de colédoco em crianças. MÉTODO: Avaliação prospectiva dos pacientes operados com o diagnóstico de cisto de colédoco em cinco anos no Hospital Municipal Jesus. RESULTADOS: Houve predomínio de casos diagnosticados pela presença de dor abdominal recorrente, icterícia e/ou massa abdominal palpável. Apenas dois pacientes apresentavam a tríade completa. Todos os pacientes foram submetidos à ultra-sonografia e houve dúvida no diagnóstico ultra-sonográfico em apenas dois. Todos eram cistos do tipo 1 de Todani tratados através de ressecção completa e anastomose biliodigestiva em Y Roux. Houve complicações pós-operatórias imediatas em três pacientes: um caso de hemorragia digestiva alta e dois casos de fístula biliar, um deles relacionado a problemas técnicos na anastomose que necessitou de reoperação. O seguimento variou de quatro meses a cinco anos, sem detecção de complicação tardia em nenhum caso. CONCLUSÕES: O tratamento do cisto de colédoco através da ressecção completa na criança é seguro, relacionado a poucas complicações e capaz de resolver por completo a sintomatologia pré-operatória dos pacientes.
BACKGROUND: Our objective is to evaluate prospectively the treatment and diagnosis of choledochal cysts in Hospital Municipal Jesus in a five-year period (1996-2001). METHOD: Prospective evaluation of patients operated on for choledochal cysts in Hospital Municipal Jesus during a five-year period. RESULTS: Patients generally presented recurring abdominal pain, jaundice or an abdominal tumor, but only two presented the complete triad. One patient was asymptomatic and was diagnosed fortuitouslly. All patients could be diagnosed by ultrasonography, and the method accomplished a doubtful diagnosis in only two cases. All cases were Todani's type 1 treated by total resection. There were three post-operative complications: an episode of digestive hemorrhage and two biliary fistulae, one clinically treated with success and one reoperated. Follow up varied between 4 months and 5 years and there weren't any late complications. CONCLUSION: Choledochal cysts must be treated electively by total resection as soon as they are diagnosed, and surgical resection is safe in children.
ABSTRACT
Anomalous union of pancraeticobiliary drain (AUPBD) is uncommon anomaly of the pancreaticobiliary ductal union system. Usually, this anomaly is confirmed by long common channel (>15 mm) at ERCP and is divided into according to relationship between pancreatic duct and common bile duct. Recently several reports showed that AUPBD may be associated with congenital choledochal cyst and gallbladder carcinoma. A 33-year old man was admitted with RUQ pain and jaundice. Ultrasonography, Abdominal CT, ERCP, and PTBD cholangiography showed type I choledochal cyst, AUPBD and focal adenomyomatosis on the gallbladder. Whipple's operation with excision of the choledochal cyst and chloecystectomy were performed for treatment. This clinical experience suggests that high incidence of choledochal cyst in patients with AUPBD and gallbladder adenomyomatosis are may be closely related to the carcinogenesis of gallbladder cancer in patients with AUPBD.