title: A rare case of choledochocele associated with pancreas divisum.
abstract: Choledochocele, type III choledochal cyst, is a rare abnormality. We report a rare case of choledochocele involving a 15-year-old girl who presented with intermittent episodes of upper abdominal pain. She underwent computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP), which revealed no abnormalities of biliary and pancreatic ducts. Endoscopic retrograde cholangiopancreatography (ERCP) initially suggested a diagnosis of pancreas divisum (PD), and so we failed to diagnose choledochocele at that time. Her condition improved and she was discharged, but she presented again with recurrent episodes of upper abdominal pain. Then, spiral computed tomography with intravenous infusion cholangiography (IVC-SCT) facilitated a diagnosis of choledochocele. The coexistence of choledochocele and pancreas divisum is extremely rare, and it is difficult to diagnose. However, this case suggests that the absence of pancreatitis does not rule out choledochal cysts, and modern imaging techniques, such as IVC-SCT, must be applied in difficult cases.
authors.affiliation: Department of Pediatric Surgery, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan. m-sonoda@kitano-hp.or.jp
authors.forename: Mari
authors.initials: M
authors.lastname: Sonoda
authors.forename: Masahito
authors.initials: M
authors.lastname: Sato
authors.forename: Yuya
authors.initials: Y
authors.lastname: Miyauchi
authors.forename: Shujiro
authors.initials: S
authors.lastname: Yazumi
authors.forename: Makiko
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000293:Adolescent; D015529:Choledochal Cyst / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D010179:Pancreas / Q000002:abnormalities*
references.citation: Pediatr Surg Int. 2004 Jan;20(1):43-6
references.pmid: 14689215
references.citation: Surgery. 1995 Apr;117(4):476-8
references.pmid: 7716732
references.citation: Int Abstr Surg. 1959 Jan;108(1):1-30
references.pmid: 13625059
references.citation: Arch Surg. 1999 Oct;134(10):1150-2
references.pmid: 10522863
references.citation: J Pediatr Surg. 2006 Oct;41(10):1645-51
references.pmid: 17011262
references.citation: Radiology. 1998 Nov;209(2):443-8
references.pmid: 9807571
references.citation: J Pediatr Surg. 1995 May;30(5):694-6
references.pmid: 7623231
references.citation: J Pediatr Surg. 1989 Jan;24(1):52-3
references.pmid: 2723996
references.citation: Ann Surg. 2000 Jun;231(6):899-908
references.pmid: 10816634
references.citation: Am J Surg. 1980 Nov;140(5):653-7
references.pmid: 6776832
references.citation: J Pediatr Surg. 1993 Dec;28(12):1562-5
references.pmid: 8301491
references.citation: J Pediatr Surg. 2006 Oct;41(10):1652-6
references.pmid: 17011263
references.citation: Am J Surg. 1977 Aug;134(2):263-9
references.pmid: 889044