BMJ Case Reports 2018; doi:10.1136/bcr-2018-224891
  • Rare disease

Giant choledochal cyst presenting during third trimester of pregnancy

  1. Luis Cruz-Benítez2
  1. 1 General Surgery, Instituto Nacional de Ciencias Medicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
  2. 2 General Surgery, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Mexico
  1. Correspondence to Dr Jorge Humberto Rodríguez-Quintero, huroqu90{at}
  • Accepted 29 May 2018
  • Published 13 June 2018


Biliary cystic disease is a rare entity. Twenty-five per cent of cases are diagnosed during adulthood and only a few reports have described this condition during pregnancy, where it represents a therapeutic challenge for both obstetricians and surgeons with regard to the risks it entails for the patient and the fetus.

Definitive management is surgical resection, as cysts may progress to malignancy if untreated. During pregnancy, resection is generally deferred to after delivery, especially in the context of suspected cholangitis.

A 19-year-old young woman with no previous prenatal control, presented to the emergency department on her 32nd week of gestation with abdominal pain and jaundice. A giant Todani I biliary cyst was observed on imaging along with dilation of the proximal biliary tree suggesting acute cholangitis. Fetal compromise prompted immediate delivery after which percutaneous biliary drainage was performed. Following recovery, the cyst was surgically resected.


  • Contributors Planning of the study was performed by JMM, JHR-Q, SC-V and LC-B. JMM and JHR-Q were responsible of conducting the study and providing insight. The conception of the case was done by JMM and JHR-Q. SC-V and LC-B were responsible for acquiring the images and data.The paper was written by JMM, JHR-Q, SC-V and LC-B. Case analysis and follow-up were done by JMM, JHR-Q, SC-V and LC-B. JMM, JHR-Q, SC-V and LC-B approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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