Spontaneous rupture of a choledochal cyst in a 11-month-old girl] |
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| Authors: | L Harper F Lavrand P Pietrera M Loot P Vergnes |
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| Affiliation: | 1. Département de chirurgie pédiatrique, hôpital Pellegrin-Enfants, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France;2. Radiologie pédiatrique, hôpital Pellegrin-Enfants, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France;1. Institut Pasteur, Département de Neuroscience, Unité Neurobiologie intégrative des systèmes cholinergiques, Paris, France;2. CNRS, UMR 3571, Paris, France;1. Registre Bourguignon des cancers digestifs, Inserm U866, université de Bourgogne, CHU de Dijon, université de Bourgogne, registre Bourguignon des cancers digestifs, Inserm U866, 21000 Dijon, France;2. Centre hospitalo-universitaire Dijon-Bourgogne, service d’hépato-gastroentérologie et d’oncologie digestive, 21000 Dijon, France;1. Division of Pediatric Urology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA;2. Division of Urology, Department of Surgical Subspecialties, National Center for Child Health and Development, Tokyo, Japan;1. Department of Urology and Pediatric Urology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands;2. Department of Urology, Maasstad Hospital, Rotterdam, the Netherlands;1. Service de médecine physique et de réadaptation fonctionnelle, CHU Ibn Rochd, Casablanca, Maroc;2. Service d’urologie, CHU Ibn Rochd, Casablanca, Maroc;3. Service de chirurgie pédiatrique, hôpital d’enfants, Casablanca, Maroc |
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| Abstract: | Choledochal cysts are rare congenital malformations of the biliary tract. Though most cysts are diagnosed incidentally, some present directly with complications. We report on the case of an 11-month-old girl admitted for abdominal pain, fever and vomiting. Ultrasonography revealed intraabdominal fluid and the absence of a choledochal cyst diagnosed 2 months earlier. Laparotomy for suspected rupture of a choledochal cyst was planned and a choledochojejunostomy with Roux-en-Y was performed. Spontaneous rupture of a choledochal cyst is rare and occurs most frequently in children under the age of 4. The exact cause is yet unknown and several factors have been implicated. The most probable cause is the combination of pancreatic reflux and epithelial irritation of a weakened cyst wall. Choledochal cysts should preferably be treated as soon as the child is 6 months old. Complete excision of the cyst is mandatory because of the risk of malignant transformation. |
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