Assuntos
Cisto do Colédoco/microbiologia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Doenças da Vesícula Biliar/microbiologia , Tuberculose/complicações , Adulto , Antituberculosos/uso terapêutico , Colangiopancreatografia Retrógrada Endoscópica , Cisto do Colédoco/diagnóstico , Cisto do Colédoco/cirurgia , Doenças da Vesícula Biliar/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tuberculose/tratamento farmacológicoRESUMO
BACKGROUND: Choledochal cyst is rarely diagnosed during pregnancy, and it is very difficult to make a diagnosis of it clinically or radiologically. CASE: A woman was diagnosed as having an ovarian cyst and gallbladder mucocele on ultrasonography in both her first and second pregnancies. She was asymptomatic, and conservative management was adopted. Three days after delivery of her second child, the patient had a sudden onset of right upper quadrant pain associated with deranged liver function. Emergency laparotomy revealed a type I choledochal cyst with evidence of infection. Excision of the cyst, cholecystectomy and bilateral hepatojejunostomy in the Roux-en-Y fashion were performed. CONCLUSION: A choledochal cyst in pregnancy is difficult to diagnose and poses a threat to mother and fetus.
Assuntos
Cisto do Colédoco/diagnóstico , Doenças da Vesícula Biliar/diagnóstico , Mucocele/diagnóstico , Complicações na Gravidez/diagnóstico , Adolescente , Colecistectomia , Cisto do Colédoco/microbiologia , Cisto do Colédoco/patologia , Cisto do Colédoco/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Infecções , Jejuno/cirurgia , Laparotomia , Fígado/cirurgia , Dor/etiologia , Gravidez , Complicações na Gravidez/patologia , Complicações na Gravidez/cirurgiaRESUMO
One to two percent of patients who have choledochal cysts present with cyst rupture and bile peritonitis. Reported cases have been managed with external drainage of the cyst followed by a second procedure to excise the cyst and reconstruct the biliary tract. The authors report two cases of ruptured choledochal cyst treated with primary cyst excision and biliary drainage. The satisfactory outcome of these patients suggests that this is the preferred management.
