Choledochocele

=Choledochocele = A choledochocele is a rare type of choledochal cyst, which is a cystic dilation of the bile duct. Specifically, a choledochocele is a cystic dilation of the distal portion of the common bile duct, which protrudes into the duodenum. This condition is classified as a type III choledochal cyst according to the Todani classification system.

Pathophysiology

Choledochoceles are believed to result from an abnormality in the development of the bile duct system. The exact cause is not well understood, but it is thought to involve a combination of genetic and environmental factors. The dilation occurs at the junction where the bile duct meets the duodenum, leading to a protrusion into the duodenal lumen.

Clinical Presentation

Patients with choledochocele may present with a variety of symptoms, although some may be asymptomatic. Common symptoms include:

• Abdominal pain
• Jaundice
• Nausea and vomiting
• Pancreatitis

In some cases, choledochoceles are discovered incidentally during imaging studies for other conditions.

Diagnosis

The diagnosis of choledochocele is typically made using imaging techniques such as:

• Magnetic Resonance Cholangiopancreatography (MRCP)
• Endoscopic Retrograde Cholangiopancreatography (ERCP)
• Ultrasound

These imaging modalities help visualize the cystic dilation and its relationship to the bile duct and duodenum.

Treatment

The treatment of choledochocele often involves endoscopic or surgical intervention. Options include:

• Endoscopic sphincterotomy: This procedure involves cutting the sphincter of Oddi to allow better drainage of the bile duct.
• Surgical resection: In some cases, surgical removal of the choledochocele may be necessary.

The choice of treatment depends on the size of the choledochocele, the presence of symptoms, and the overall health of the patient.

Prognosis

The prognosis for patients with choledochocele is generally good, especially if the condition is diagnosed and treated early. Complications such as pancreatitis or cholangitis can occur if the condition is left untreated.

See Also

• Choledochal cyst
• Bile duct
• Pancreatitis
• Todani, T., et al. "Classification of congenital biliary cystic disease: special reference to type of cystic disease and surgical treatment." Journal of Hepato-Biliary-Pancreatic Surgery 2.2 (1995): 130-134.
• Lee, H. K., et al. "Choledochocele: MR cholangiopancreatography findings in five cases." Abdominal Imaging 28.5 (2003): 660-664.

NIH genetic and rare disease info

• NIH info on Choledochocele

Choledochocele is a rare disease.