Imaging Diagnosis of a Giant Abdominal Cyst in an Infant

Abstract

The usual etiologies of giant abdominal cystic masses in infants are mesenteric cyst, enteric duplication cyst, ovarian cyst in females, cystic lymphangioma, and the presentation of a choledochal cyst in a gigantic form is however, unusual. The primary modality for diagnosis of this entity is ultrasound, followed by MRI. The characteristic ultrasound features of a choledochal cyst are a well-defined cystic lesion which may be replacing any segment of biliary tree and is distinctly separate from the gallbladder. The associated anomalies are biliary atresia, gallbladder atresia, hepatic fibrosis and also anomalies of the pancreatico-biliary system. MRI with MRCP has a conclusive role in confirming the ultrasound diagnosis. Choledochal cysts are classified based on Todani et al.’s method as comprising of five types. Herein we report the case study of a 4 month old male infant afflicted with a gigantic Type 1 Choledochal cyst, which was diagnosed by us at the first instance itself by ultrasound examination and was corroborated by MRI. The diagnosis was further confirmed at surgery and histopathology. The recommended treatment of resection of the cyst accompanied by a hepatico-jejunostomy by pass procedure, was successfully performed in the reported infant.

Keywords: Choledochal cyst, Giant abdominal cyst, Infant, MRI, Ultrasound features.

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