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Giant Choledochal Cyst in an Adult at a Teaching Hospital in South-Western Uganda: A Case Report

BACKGROUND: Choledochal cysts are rare congenital malformations characterized by cystic dilatations of the biliary tree. They are more prevalent in East Asian populations, but uncommon in western countries, and scarcely reported in African nations. They are classically diagnosed in children, and onl...

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Autores principales: Sikhondze, Mvuyo Maqhawe, Cabrera Dreque, Carlos, Tayebwa, Edson, Tumubugane, Gotharido, Odongo, Charles Newton, Ogwang, Eugene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627307/
https://www.ncbi.nlm.nih.gov/pubmed/34849036
http://dx.doi.org/10.2147/IMCRJ.S340751
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author Sikhondze, Mvuyo Maqhawe
Cabrera Dreque, Carlos
Tayebwa, Edson
Tumubugane, Gotharido
Odongo, Charles Newton
Ogwang, Eugene
author_facet Sikhondze, Mvuyo Maqhawe
Cabrera Dreque, Carlos
Tayebwa, Edson
Tumubugane, Gotharido
Odongo, Charles Newton
Ogwang, Eugene
author_sort Sikhondze, Mvuyo Maqhawe
collection PubMed
description BACKGROUND: Choledochal cysts are rare congenital malformations characterized by cystic dilatations of the biliary tree. They are more prevalent in East Asian populations, but uncommon in western countries, and scarcely reported in African nations. They are classically diagnosed in children, and only 20–30% of cases are diagnosed in adulthood. Giant choledochal cysts are those with sizes exceeding 10cm, and are extremely rare with a few reported in the literature, thus the need for this case report. CASE: A 25-year-old Ugandan woman presented with an 8-month history of abdominal pain, jaundice and progressively increasing right upper quadrant abdominal mass. She underwent trans-abdominal ultrasonography that revealed a large, well-defined, echo-free mass in the right upper quadrant, extending to the lumbar region. Abdominal computed tomography (CT) revealed a huge thin-walled, cystic mass rising from the right wall of common hepatic duct, displacing the surrounding structures and no visible common bile duct. Complete cyst excision of a giant choledochal cyst type IVa was performed without decompression, in addition to cholecystectomy and reconstruction with hepaticojejunostomy and jejunojejunostomy anastomoses. CONCLUSION: Giant choledochal cysts are a very rare pathology worldwide. Diagnosis can still be made using ultrasound and CT where more advanced imaging modalities like endoscopic retrograde cholangiopancreatography (ERCP) are not available. Complete surgical resection of giant choledochal cysts is surgically challenging, but essential to relieve symptoms and prevent malignant transformation. To the best of our knowledge, this is the first reported case in the literature, of a giant choledochal cyst that was successfully treated in an African nation.
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spelling pubmed-86273072021-11-29 Giant Choledochal Cyst in an Adult at a Teaching Hospital in South-Western Uganda: A Case Report Sikhondze, Mvuyo Maqhawe Cabrera Dreque, Carlos Tayebwa, Edson Tumubugane, Gotharido Odongo, Charles Newton Ogwang, Eugene Int Med Case Rep J Case Report BACKGROUND: Choledochal cysts are rare congenital malformations characterized by cystic dilatations of the biliary tree. They are more prevalent in East Asian populations, but uncommon in western countries, and scarcely reported in African nations. They are classically diagnosed in children, and only 20–30% of cases are diagnosed in adulthood. Giant choledochal cysts are those with sizes exceeding 10cm, and are extremely rare with a few reported in the literature, thus the need for this case report. CASE: A 25-year-old Ugandan woman presented with an 8-month history of abdominal pain, jaundice and progressively increasing right upper quadrant abdominal mass. She underwent trans-abdominal ultrasonography that revealed a large, well-defined, echo-free mass in the right upper quadrant, extending to the lumbar region. Abdominal computed tomography (CT) revealed a huge thin-walled, cystic mass rising from the right wall of common hepatic duct, displacing the surrounding structures and no visible common bile duct. Complete cyst excision of a giant choledochal cyst type IVa was performed without decompression, in addition to cholecystectomy and reconstruction with hepaticojejunostomy and jejunojejunostomy anastomoses. CONCLUSION: Giant choledochal cysts are a very rare pathology worldwide. Diagnosis can still be made using ultrasound and CT where more advanced imaging modalities like endoscopic retrograde cholangiopancreatography (ERCP) are not available. Complete surgical resection of giant choledochal cysts is surgically challenging, but essential to relieve symptoms and prevent malignant transformation. To the best of our knowledge, this is the first reported case in the literature, of a giant choledochal cyst that was successfully treated in an African nation. Dove 2021-11-23 /pmc/articles/PMC8627307/ /pubmed/34849036 http://dx.doi.org/10.2147/IMCRJ.S340751 Text en © 2021 Sikhondze et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Case Report
Sikhondze, Mvuyo Maqhawe
Cabrera Dreque, Carlos
Tayebwa, Edson
Tumubugane, Gotharido
Odongo, Charles Newton
Ogwang, Eugene
Giant Choledochal Cyst in an Adult at a Teaching Hospital in South-Western Uganda: A Case Report
title Giant Choledochal Cyst in an Adult at a Teaching Hospital in South-Western Uganda: A Case Report
title_full Giant Choledochal Cyst in an Adult at a Teaching Hospital in South-Western Uganda: A Case Report
title_fullStr Giant Choledochal Cyst in an Adult at a Teaching Hospital in South-Western Uganda: A Case Report
title_full_unstemmed Giant Choledochal Cyst in an Adult at a Teaching Hospital in South-Western Uganda: A Case Report
title_short Giant Choledochal Cyst in an Adult at a Teaching Hospital in South-Western Uganda: A Case Report
title_sort giant choledochal cyst in an adult at a teaching hospital in south-western uganda: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627307/
https://www.ncbi.nlm.nih.gov/pubmed/34849036
http://dx.doi.org/10.2147/IMCRJ.S340751
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