Stipsanelli E, Valsamaki P, Tsiouris S, Arka A, Papathanasiou G, Ptohis N, Lahanis S, Papantoniou V, Zerva C. Spontaneous rupture of a type IVA choledochal cyst in a young adult during radiological imaging. World J Gastroenterol 2006; 12(6): 982-986 [PMID: 16521234 DOI: 10.3748/wjg.v12.i6.982]
Corresponding Author of This Article
Dr Pipitsa Valsamaki, ‘ALEXANDRA’ University Hospital, Department of Nuclear Medicine, 80, Vas. Sophia’s Ave. & 2, K. Lourou Str., 115 28 Athens, Greece. pivals@gmail.com
Article-Type of This Article
Case Report
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Ekaterini Stipsanelli, Pipitsa Valsamaki, Spyridon Tsiouris, Angelika Arka, Georgios Papathanasiou, Vassilios Papantoniou, Cherry Zerva, Department of Nuclear Medicine, ‘ALEXANDRA’ University Hospital, 80, Vas. Sophia’s Ave. & 2, K. Lourou Str., 115 28 Athens, Greece
Nikolaos Ptohis, Department of Radiology, ‘ALEXANDRA’ University Hospital, 80, Vas. Sophia’s Ave. & 2, K. Lourou Str., 115 28 Athens, Greece
Stephanos Lahanis, Department of Radiology, 401 General Military Hospital, Mesogheion Ave. & 3, Kanelopoulou Str., 115 25 Athens, Greece
Correspondence to: Dr Pipitsa Valsamaki, ‘ALEXANDRA’ University Hospital, Department of Nuclear Medicine, 80, Vas. Sophia’s Ave. & 2, K. Lourou Str., 115 28 Athens, Greece. pivals@gmail.com
Received: March 23, 2005 Revised: April 11, 2005 Accepted: July 28, 2005 Published online: February 14, 2006
Abstract
A case of a 24-year-old male with jaundice and epigastric pain is reported. The patient underwent a thorough clinical, laboratory, and imaging investigation. Computerized tomography revealed a 9 cm×10 cm choledochal cyst. Magnetic resonance imaging and magnetic cholangiopancreatography were performed, during which he developed an “acute abdomen”, with radiological evidence of biliary peritoneal leak. Urgent surgery revealed rupture of the distended malformed common bile duct. A peritoneal drain was instilled and a more definitive surgical procedure was accordingly scheduled. Hepatobiliary scintigraphy following surgery verified these findings, as well as confirmed the adequacy of the urgent surgery. A combination of radiological and nuclear medicine techniques substantially contributes to the diagnosis of choledochal cyst rupture and the adequacy of surgical intervention.
