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A giant choledochal cyst in 8 years old female



Abstract

Choledochal cyst incidence in Asian population is 1 : 1000 live births and more common in female. The classic triad can be found in younger children is icteric, abdominal pain, and palpable mass in the abdomen. Various technique has been performed, but cyst excision and Roux-en-Y hepaticojejunostomy still prefered. Inappropriate management can cause several complications. We describe a rare case of Giant Choledocal Cyst, 8 years old female present abdominal pain and a palpable mass in abdomen from below arcus costae to right inguinal region. Laboratory finding show serum bilirubin, alkaline phosphatase, gamma-glutamyl transferase level are elevated. Computered tomography scan shows type IV choledochal cyst, with size 117.1 x 83.5 mm. First step surgery, external drainage was performed. The definitive surgery was incomplete cyst excision and Roux-en-Y hepaticojejunostomy. The patient was discharged in good condition. The long-term prognostic is dubia ad bonam, biliary tract malignancy may still occur.

Insiden kista koledokus di Asia adalah 1 : 1000 kelahiran hidup dan lebih banyak pada perempuan. Trias klasik pada anak adalah ikterus, nyeri perut, dan teraba massa di abdomen. Beberapa teknik dapat dilakukan namun paling baik adalah eksisi kista dan Roux- en-Y hepatikojejunostomi. Kami melaporkan sebuah kasus jarang giant choledocal cyst pada perempuan 8 tahun dengan keluhan nyeri perut dan teraba massa di bawah arkus kosta sampai inguinal kanan. Laboratorium menunjukkan peningkatan serum bilirubin, alkaline fosfatase, dan gamma-glutamil transferase. Computered tomography scan menunjukkan kista koledokus tipe IV, ukuran 117,1 x 83,5 mm. Pembedahan tahap pertama adalah drainase eksternal. Pembedahan de nitif adalah eksisi kista parsial dan Roux-en-Y hepaticojejunostomi. Pasien pulang dalam kondisi baik. Prognosis jangka panjang dubia ad bonam, dan keganasan saluran bilier dapat terjadi.

 

 

Keywords: Giant Choledocal Cyst Roux-en-Y hepaticojejunostomy

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How to Cite

Sapulete, E. J., Putra, I. G. N. S., Karyana, I. P. G., Nesa, N. N. M., Darmajaya, I. M., & Ariyanta, K. D. (2019). A giant choledochal cyst in 8 years old female. Medicina, 50(2). https://doi.org/10.15562/medicina.v50i2.110
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Eva JJ Sapulete
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I Gusti Ngurah Sanjaya Putra
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I Putu Gede Karyana
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Ni Nyoman Metriani Nesa
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I Made Darmajaya
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Kadek Deddy Ariyanta
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