Preoperative cholangioscopic identification of traumatic type IVa choledochal cyst perforation after motor vehicle collision: A case report

doi:10.12998/wjcc.126222

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Cases. Sep 16, 2026; 14(26): 126222
Published online Sep 16, 2026. doi: 10.12998/wjcc.126222

Preoperative cholangioscopic identification of traumatic type IVa choledochal cyst perforation after motor vehicle collision: A case report

Liana Ysabel Almendras Bautista, Michelle Lee, Kartik Devgan, Jaron Longo, Sylvia Singh, Kenaz Bakdash, Moiz Ahmed, Rohit Agrawal

Liana Ysabel Almendras Bautista, Department of Internal Medicine, University of Illinois Hospital and Health System, Chicago, IL 60612, United States

Michelle Lee, Kartik Devgan, Jaron Longo, Department of Internal Medicine, Loyola University Medical Center, Maywood, IL 60153, United States

Sylvia Singh, Department of Internal Medicine, Marian University College of Osteopathic Medicine, Indianapolis, IN 46222, United States

Kenaz Bakdash, Department of Radiology, Radiology of Indiana, Indianapolis, IN 46256, United States

Moiz Ahmed, Department of Gastroenterology, Community Health Network, Indianapolis, IN 46219, United States

Rohit Agrawal, Department of Gastroenterology, Loyola University Medical Center, Maywood, IL 60153, United States

Author contributions: Bautista LYA, Ahmed M, and Agrawal R contributed to conceptualization and design; Bautista LYA, Lee M, Devgan K, Longo J, Singh S, Bakdash K, and Ahmed M contributed to data acquisition, analysis, interpretation; Bautista LYA, Lee M, Devgan K, Singh S, Ahmed M, and Agrawal R contributed to article drafting and review; Bautista LYA, Lee M, Devgan K, Longo J, Singh S, Bakdash K, Ahmed M, and Agrawal R contributed to final approval of article; Bautista LYA is the article guarantor.

AI contribution statement: AI tools (specifically Grammarly) were used solely for language editing and proofreading. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and its accompanying images.

Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Liana Ysabel Almendras Bautista, MD, Department of Internal Medicine, University of Illinois Hospital and Health System, 1740 W Taylor St., Chicago, IL 60612, United States. lianaysabelbautista@gmail.com

Received: July 28, 2026
Revised: September 7, 2026
Accepted: September 17, 2026
Published online: September 16, 2026
Processing time: 52 Days and 12.2 Hours

Core Tip

Core Tip: Traumatic rupture or perforation of a previously undiagnosed choledochal cyst in an adult is a rare cause of biliary injury and may mimic common conditions such as choledocholithiasis. Hemobilia or trauma-associated biliary obstruction should raise suspicion for occult biliary tree injury. Endoscopic retrograde cholangiopancreatography combined with cholangioscopy can directly visualize subtle duct injuries not apparent on initial imaging. Cholecystostomy tube placement may be a helpful bridge to surgery by improving source control in clinically stable patients. Early evaluation with cholangioscopy can facilitate preoperative delineation of biliary anatomy, guiding early diagnostic accuracy of biliary cysts, excision, and reconstruction.