Strictures, stones and cysts: an unusual cause of pancreatitis in a 20-month-old female child

• Published in: BMJ case reports Vol. 13; no. 7; p. e234966
• Main Authors: Zufall, Alina, Middleton, Jeremy P, Rasmussen, Sara, Daugherty, Reza J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 08.07.2020; BMJ Publishing Group
• Series: Case report
• Subjects: Abdomen; Acute Disease; Antigens; Bile; Calculi - complications; Calculi - diagnosis; Case reports; Children & youth; Choledochal Cyst - complications; Choledochal Cyst - diagnosis; Constriction, Pathologic - complications; Constriction, Pathologic - diagnosis; Cysts; Diagnosis, Differential; Emergency medical care; Endoscopy; Female; Gallbladder; Gastroenterology; Humans; Infant; Laboratories; Medical Illustration; Pain; Pancreas; Pancreatic Diseases - complications; Pancreatic Diseases - diagnosis; Pancreatitis; Pancreatitis - diagnosis; Pancreatitis - etiology; Pediatrics; Preschool children; Rare Disease; Ultrasonic imaging; Vomiting; pancreas and biliary tract; paediatric surgery; GAstroenterology; pancreatitis; radiology
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-234966

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.