Choledocal cyst: the radiological evaluation

The authors have experienced 11 cases of radiologically or surgically proven choledochal cyst during the period of 4 years, and reviewed radiological and clinical features. The results are as follows: 1. The sex ratio of female to male was 2.7:1. Four were children under 10, and seven were adults over 30 years of age. 2. The most frequent symptom was abdominal pain (45%), which was followed by jaundice (36%) and palpable abdominal mass (27%). 3. Morphologically, 4 cases were type A of Kimura classification (segmental cystic dilatation involving common bile duct; pure type A of Alonso-Lej). The other 7 patients showed some dilatation in the intrahepatic bile ducts as well; i.e. type A' of Kimura classification. 4. The union between the common bile and main pancreatic ducts was at a high position in 5 of 6 patients in whom both ducts were adequately opacified with ERCP, PTC and/or operative cholangiography, forming an abnormally long common channel. 5. Associated choledocholithiasis was reported with increasing frequency. We experienced 4 cases (36.3%) which had multiple stones in the choledochal cyst. 6. Adenocarcinoma were combined in 2 patients; both were females of 38 and 45 years of age. 7. Ten cases were correctly diagnosed preoperatively with ultrasonography. Specific ultrasound diagnosis of a choledochal cyst could be made by identifying two bile ducts entering into the large cyst which was separated from the gallbladder and extended deep onto the portal hepatic. Dilatation of intrahepatic ducts could be easily identified.