Spontaneous choledochal cyst perforation in pregnancy with co-existent chronic pancreatitis.
Choledochal cysts are a congenital disorder of the bile duct, usually presenting in childhood. As they cause weakening of the wall of the bile duct, any distal obstruction, infection or reflux of amylase-rich fluid in the biliary tract can predispose to spontaneous perforation. A 25-year-old pregnant woman at 35 weeks of gestation presented with acute abdominal and fetal distress. On emergency laparotomy, common bile duct perforations were detected. T-tube drainage and caesarean section were performed. A t-tube cholangiogram revealed the diagnosis of a choledochal cyst with an abnormal pancreatobiliary junction and chronic pancreatitis. The patient later underwent cyst excision with Roux en Y hepaticojejunostomy. Spontaneous choledochal cyst perforation in pregnancy can be successfully managed by a two-stage operation.
Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Harjeet
H
Singh
Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Rahul
http://orcid.org/0000-0001-7461-2083
R
Gupta
Department of Gynaecology and Obstetrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Lakhbir
L
Dhaliwal
Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Rajinder
R
Singh
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D002585:Cesarean Section / Q000379:methods; D002758:Cholangiography / Q000379:methods; D015529:Choledochal Cyst / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004638:Emergency Treatment; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007813:Laparotomy / Q000379:methods; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011256:Pregnancy Outcome; D018570:Risk Assessment; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal