Abstract
Choledochal cysts usually present with abdominal pain, jaundice, abdominal lump and in various combinations, however, sometimes it may present in unusual manner like hepatolithiasis, portal hyper-tension, spontaneous perforation, and biliary tract malignancy. Here we report case of adult choledochal cyst with carcinoma gall bladder which is very uncommon. Cholangiocarcinoma is the most common malignancy associate in patients with the choledochal cyst; however, carcinoma gall bladder could also be associated with this entity due to the possible occurrence of anomalous pancreatobiliary ductal junction which leads to continuous reflux of activated pancreatic enzymes, amylase, and bile stasis contribute proliferation of bile duct wall in presence of choledochal cysts. A high index of suspicion is needed for early diagnosis and management of these two entities. Ultrasound is first line of investigation followed by MRI protocol including MRCP, T2WI, T1WI and contrast study is quite useful to delineate type of choledochal cysts, biliary anatomy, congenital anomalies and level of biliary duct infiltration / obstruction and extent & characterisation of tumor which is important for planning management.
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Corresponding Author
Dr Ashok Kumar
Associate Professor, Department of Surgical Gastroenterology
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India
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