Echinococcus Cyst Mimicking Choledochal Cyst in Childhood

Abstract

Choledochal cyst is a rare congenital dilatation of the common bile duct, often associated with a congenital or acquired dilatation of intra-hepatic ducts. The classic symptoms of abdominal mass, pain and jaundice is rarely seen during childhood. Some children may not show symptoms for years. In most patients the diagnosis can be confirmed by using ultrasound pictures or by injecting a radioactive substance and performing a tomography scan which gives an "image" of the abnormal duct. Echinococcus granulosus is often seen in the pediatric surgical practice in endemic areas, and present with various clinical and surgical pictures such as obstructive jaundice. We had under our care a 2-year old girl who choledochal cyst with the posterior wall of choledochus, which resulted extrahepatic ductal obstruction and choledochus displaced anterolaterally. Any suspected radiologic lesion observed in infant, or child patient in an endemic area should be evaluated for hydatic cyst.©2008, Firat University, Medical Faculty.

Keywords

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Çocuk Çağında Koledok Kistini Taklit Eden Hidatik Kist Olgusu

Öz

Koledok kisti ortak safra kanalının nadir konjenital kistik dilatasyonudur, sıklıkla intra-hepatik kanalların konjenital veya edinsel dilatasyonuyla birlikte görülür. Abdominal kitle, ağrı, sarılık klasik semptomları olup çocukluk çağında nadiren görülür. Bazı çocuklarda ise semptomlar yıllarca görülmeyebilir. Tanı ultrasonografi veya radyoaktif madde verilip, bilgisayarlı tomografide anormal kanal görüntüsüyle doğrulanabilir. Echinococcus granulosus endemik bölgelerde çocuk cerrahi kliniklerinde sık rastlanır ve tıkayıcı sarılık gibi değişik klinik ve cerrahi tablolarla karşımıza çıkar. Biz ekstahepatik kanalda tıkanıklık ve koledokun arka duvarında anterolateral yerleşim gösteren koledok kistine sahip 2 yaşında kız olguyu izledik. Endemik bölgelerde, bebek veya çocuklarda şüpheli radyolojik lezyonlarda hidatik kist akılda tutulmalıdır.©2008, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler

• Hidatik kist, koledok kisti

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13. Kabul Tarihi: 23.07.2007