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Rare disease
Case report
Strictures, stones and cysts: an unusual cause of pancreatitis in a 20-month-old female child
  1. Alina Zufall1,
  2. Jeremy P Middleton2,
  3. Sara Rasmussen3 and
  4. Reza J Daugherty4
  1. 1University of Virginia School of Medicine, Charlottesville, Virginia, USA
  2. 2Pediatric Gastroenterology, University of Virginia Health System, Charlottesville, Virginia, USA
  3. 3Pediatric Surgery, University of Virginia Health System, Charlottesville, Virginia, USA
  4. 4Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA
  1. Correspondence to Ms Alina Zufall; agz8pv{at}hscmail.mcc.virginia.edu

Abstract

Choledochal cysts are dilations of the biliary tree that cause a variety of clinical symptoms and can lead to several types of complications. Choledochal cysts are most commonly diagnosed in childhood and frequently present with abdominal pain, jaundice and, in infants, an abdominal mass. Although the most concerning complication is malignant transformation of the cyst epithelium, other complications such as stone formation, acute pancreatitis and stricture can also occur and lead to patient morbidity. Treatment is aimed at not only relieving patient symptoms, but also decreasing a long-term cancer risk. We present a case of a child presenting with abdominal pain and vomiting secondary to a type IVa choledochal cyst complicated by acute pancreatitis, a common bile duct stricture and cystolithiasis.

  • GAstroenterology
  • pancreas and biliary tract
  • pancreatitis
  • radiology
  • paediatric surgery

http://dx.doi.org/10.1136/bcr-2020-234966

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    Footnotes

    • Contributors AZ and JPM contributed equally to this work. AZ was responsible for the conception of the work, initial draft and minor revisions. JPM was responsible for all major edits and revisions. SR was added to the paper during revisions and contributed to all information regarding the surgical procedure in the background and discussion. RJD was responsible for providing all medical imaging and captions.

    • 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 for publication Parental/guardian consent obtained.

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