[Value of magnetic resonance cholangiography in the diagnosis of common bile duct cystic dilation].
BACKGROUND
Magnetic resonance cholangiography is a noninvasive method for exploring the biliary and pancreatic ducts. Allergic risk is reduced as no contrast agent is required and there is no risk of infectious contamination due to catheterism. Unlike endoscopic retrograde cholangiography which requires anesthesia, there is no risk of morbidity. We report one observation of Todani type Ia cystic dilation of the main bile duct explored preoperatively with MR-cholangiography.


METHODS
A 39-year-old woman complained of acute abdominal pain. Physical examination revealed jaundice and fever. MR-cholangiography gave the diagnosis of angiocholitis with cystic dilatation of the main bile duct (type Ia). Surgery was indicated. The procedure included a Y-loop hepato-jejunal anastomosis and cholecystectomy. The postoperative period was uneventful. Pathology reported a cystic formation with no signs of malignancy.


CONCLUSIONS
Common manifestations of congenital cystic dilatation of the main bile duct are biliary pain, fever and jaundice. The MR-cholangiogram provides a map of the bile duct system directly with a noninvasive procedure. The map may be obtained in several planes to guide surgery. Indeed, since cholangiocarcinoma is found in numerous cases, surgery is a formal indication in patients with angiocholitis.
Service de Pathologie digestive, Hôpital d'Instruction des Armées Begin, Saint-Mandé.
D
D
Mennecier
G
G
Savoye
A A
AA
Aït Ameur
P
P
Cadot
J A
JA
Bronstein
C
C
Molinié
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D002758:Cholangiography / Q000379:methods*; D002761:Cholangitis / Q000209:etiology*; D002763:Cholecystectomy; D015529:Choledochal Cyst / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011300:Preoperative Care
Intérêt de la cholangio-IRM dans le diagnostic de la dilatation kystique du cholédoque.