Year 2019 / Volume 111 / Number 2
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Todani Ic cystic dilatation of the bile duct

155-156

DOI: 10.17235/reed.2018.5609/2018

Javier Gómez Sánchez, José Rubio López, Beatriz Pérez Cabrera, Benito Mirón Pozo,

Abstract
The congenital dilation of the bile duct is an infrequent pathology in western countries and is associated with the female sex. It is usually diagnosed clinically with complementary tests and evaluated at an early age and also appears frequently in adults. These dilatations are grouped into five types according to Todani’s classification, including type Ic (Figure 1). The treatment of choice for dilatations of the biliary duct Todani type I is the complete excision of the biliary tract due to the susceptibility of malignant degeneration. A reconstruction is performed via a hepaticojejunostomy with a Roux-en-Y loop. Although in non-malignant cases, a papillotomy with prophylactic stent placement using ERCP can be performed as an alternative. We present the case of a 54-year-old female with a history of high blood pressure, she was examined due to generalized abdominal pain which was unrelated to food intake. The blood test did not identify any alterations of interest. Ultrasound identified a fusiform dilation of the common bile duct occupied by lithiasis. ERCP was attempted due to choledocholithiasis, but the procedure was abandoned as it was not feasible to channel the duodenal papilla. The study was completed with NMR cholangiography (transverse plane [Figure 2] and coronal plane [Figure 3]), identifying a diffuse fusiform dilatation of the common bile duct and common hepatic duct, compatible with congenital cystic lesion Todani type Ic. Finally, the patient underwent a hepaticojejunostomy after sectioning of the main bile duct and extraction of choledocholithiasis.
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09/09/2019 23:15:43
yo soy radiologo


References
Elias Dominguez-Comesaña. Dilataciones congénitas de la vía biliar. Cir Esp 2010;88:285-91 - DOI: 10.1016/j.ciresp.2010.04.003
B. Nagi,R. Kochhar,D. Bhasin et all. Endoscopio retrograde cholangiopancreatography in the evaluation of anomalous junction of the pancreaticobiliary duct and related disorders. Abdomin Imaging, 28 (2003), pp. 847-852
Jonathan A. Sánchez, Susana Gómez, Cristian Morales, et all. Quistes del Colédoco. Rev Colomb Cir. 2015;30:296-305
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Gómez Sánchez J, Rubio López J, Pérez Cabrera B, Mirón Pozo B. Todani Ic cystic dilatation of the bile duct. 5609/2018


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Publication history

Received: 18/03/2018

Accepted: 05/06/2018

Online First: 04/10/2018

Published: 01/02/2019

Article Online First time: 200 days

Article editing time: 320 days


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