Year 2024 / Volume 116 / Number 9
Letter
Choledococele as a cause of recurrent abdominal pain and biliary sepsis

506-508

DOI: 10.17235/reed.2023.10018/2023

Irene Andaluz García, Javier Pérez-Bedmar Delgado, Concepción Fernández de la Plaza Román, Beatriz de Cuenca Morón,

Abstract
We report the case of a 91-year-old female with acute cholangitis and long-standing symptoms of recurrent colic- related abdominal pain after cholecystectomy. She was diagnosed by abdominal CT of saccular dilation of the intramural bile duct in the duodenum suggesting choledococele. ERCP was performed in which the presumptive diagnosis was confirmed, and choledochotomy and choledochoplasty were done with excellent subsequent progress. Choledococele is the least common type of biliary cyst. It consists of a cystic dilation of the intramural portion of the common bile duct that protrudes into the duodenal lumen and causes symptoms of recurrent abdominal pain and biliary events. ERCP is a key test in both diagnosis and treatment except when they cannot be approached by this technique or malignancy is suspected.
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References
[1] Ziegler KM, Pitt HA, Zyromski NJ, et al. Choledochoceles: are they choledochal cysts? Ann Surg. 2010 Oct;252(4):683-90. doi: 10.1097/SLA.0b013e3181f6931f. PMID: 20881775
[2] Lobeck IN, Dupree P, Falcone RA et al. The presentation and management of choledochocele (type III choledochal cyst): A 40-year systematic review of the literature. J Pediatr Surg. 2017 Apr;52(4):644-649. doi: 10.1016/j.jpedsurg.2016.10.008. Epub 2016 Oct 20. PMID: 27829523.
[3] Orr J, Alexopoulos S, Gamboa A. Needle-knife papillotomy of a choledochocele: a safe solution for a technically challenging dilemma. VideoGIE. 2020 Jun 16;5(8):362-363. doi: 10.1016/j.vgie.2020.04.019. PMID: 32821867; PMCID: PMC7426654.
[4] Del Pozo-García AJ, Hernán P, Serrano JA, et al. Endoscopic view of the intrahepatic biliary ducts by direct per-oral cholangioscopy in a patient with a choledochal cyst. Rev Esp Enferm Dig. 2022 May;114(5):300-301. doi: 10.17235/reed.2022.8551/2021. PMID: 35034457.
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Andaluz García I, Pérez-Bedmar Delgado J, Fernández de la Plaza Román C, de Cuenca Morón B. Choledococele as a cause of recurrent abdominal pain and biliary sepsis. 10018/2023


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Publication history

Received: 12/10/2023

Accepted: 17/10/2023

Online First: 06/11/2023

Published: 09/09/2024

Article Online First time: 25 days

Article editing time: 333 days


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