title: Type IV-a choledochal cyst--a rare adolescent presentation as acute abdomen.
abstract: A 17-year-old adolescent girl from El Salvador presented to the emergency room (ER) with severe abdominal pain associated with one episode of nausea and vomiting. The pain that started 5 days earlier was sharp in nature and epigastric in location with radiation to back and was relieved by half a tablet of Vicodin. The patient has a history of intermittent epigastric pain for the past 2 years and was treated for Helicobacter pylori for 1 year. In the ER, the serum chemistry demonstrated elevated amylase. Further workup with abdominal ultrasonography (US), computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and hepatobiliary scintigraphy confirmed a type IV-a choledochal cyst with intra- and extrahepatic dilation of bile ducts. We report an unusual acute abdomen presentation of type IV-a choledochal cyst in a 17-year-old young adult from El Salvador.
authors.affiliation: Nuclear Medicine, Clinical Science Building, Room 2.474, 301 University Boulevard, Galveston, TX 77555-0793, USA.
authors.forename: Ramadass
authors.initials: R
authors.lastname: Satya
authors.forename: Vani
authors.initials: V
authors.lastname: Vijayakumar
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D000293:Adolescent; D049448:Cholangiopancreatography, Magnetic Resonance; D015529:Choledochal Cyst / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional