title: Two Cases of Plug or Stone in Remnant Intrapancreatic Choledochal Cysts Treated with Endoscopic Retrograde Cholangiopancreatography.
abstract: Incomplete resection of choledochal cysts (CCs) that extend deep into the pancreas can lead to protein plug or stone formation, pancreatitis, and cholangiocarcinoma. We encountered two cases of choledocholithiasis in remnant intrapancreatic CCs, in which the patients exhibited symptoms after 3 and 21 years of cyst excision. A 21-year-old woman who had undergone excision of a CC, as a neonate, presented with epigastric pain. Abdominal computed tomography (CT) revealed stones inside the remnant pancreatic cyst, which were removed by endoscopic retrograde cholangiopancreatography (ERCP), and her symptoms improved. A 33-year-old woman, who underwent cyst excision 3 years ago, presented with pancreatitis. Abdominal CT showed a radiolucent plug inside the remnant pancreatic cyst. The soft, whitish plug was removed by ERCP, and the pancreatitis improved. These cases indicate that plugs and stones in CCs have the same pathogenetic mechanism, and their form depends on the time since the incomplete excision surgery.
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Chungbuk, Korea.
authors.forename: Eunbee
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Radiology, Chungbuk National University College of Medicine, Chungbuk, Korea.
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Kang
authors.affiliation: Department of Radiology, Chungbuk National University College of Medicine, Chungbuk, Korea.
authors.forename: Jisun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Surgery, Chungbuk National University College of Medicine, Chungbuk, Korea.
authors.forename: Hanlim
authors.initials: H
authors.lastname: Choi
authors.affiliation: Department of Surgery, Chungbuk National University College of Medicine, Chungbuk, Korea.
authors.forename: Jae-Woon
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Chungbuk, Korea.
authors.forename: Joung-Ho
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Chungbuk, Korea.
authors.forename: Seon Mee
authors.initials: SM
authors.lastname: Park
keywords: Abdominal pain; Acute pancreatitis; Choledochal cyst, intrapancreatic remnant; Cholelithiasis