Cholelithiasis and choledocholithiasis associated with anomalous junction of the cystic duct in a child.
We report an extremely rare case of cholelithiasis, presumably owing to cholestasis resulting from an anomalous course of the cystic duct. A 10-year-old girl visited our hospital because of right epigastric pain and fever. Cholelithiasis and choledocholithiasis were diagnosed by ultrasound examination. Magnetic resonance cholangiopancreatography showed no pancreaticobiliary maljunction but confirmed a dilated, tortuous cystic duct anomalously draining into the right hepatic duct. Because cholangitis and obstructive jaundice progressed after admission, emergent endoscopic retrograde cholangiopancreatography was performed, and a common bile duct stone was removed endoscopically. It was a bilirubin stone. At a later date, laparoscopic cholecystectomy was performed for cholelithiasis. Preoperative 3-dimensional computed tomography and intraoperative cholangiography enabled us to treat the cystic duct safely.
Yanagisawa
Satohiko
S
Department of Pediatric Surgery, Jichi Medical University, Tochigi 329-0498, Japan. s.yanagisawa@jichi.ac.jp
Oue
Takaharu
T
Odashima
Takayuki
T
Kuda
Masaaki
M
Tanabe
Yoshihide
Y
Yokomori
Kinji
K
D002648:Child; D002758:Cholangiography / Q000379:methods; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002779:Cholestasis / Q000209:etiology; D003549:Cystic Duct / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006500:Hepatic Duct, Common / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional; D011300:Preoperative Care / Q000379:methods; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed