Antenatal diagnosis and early surgery for choledochal cyst

Charles G. Howell, John M. Templeton, Stuart Weiner, Mark Glassman, James M. Betts, C. L. Witzleben

Research output: Contribution to journalArticle

87 Scopus citations

Abstract

The pathogenesis and optimal treatment of choledochal cyst have long remained questions of considerable speculation and dispute. Because the pregnancy of a 37-year-old woman was felt to be at risk, five antenatal ultrasound examinations were made. The fourth examination at 31.5 weeks of gestation demonstrated a choledochal cyst. Following birth, the child was studied with repeat ultrasound examinations and scintigraphy. The results of these studies plus the findings at surgery contributed new evidence regarding the possible pathogenesis and optimal treatment of choledochal cysts. Although the time at which the cyst originated is compatible with the concept of reflux of pancreatic juice into the common duct, no abnormal junction of the pancreatic and common duct was identified. No evidence of obstruction as part of the pathogenesis could be demonstrated. Progressive changes in the choledochal cyst in the first ten days of life suggested that delay in diagnosis and treatment of a choledochal cyst may contribute to early complications such as cholangitis. Early excision of the cyst in the newborn is considered to be the optimal treatment and may pose less risk to the patient than delayed surgical exploration.

Original languageEnglish (US)
Pages (from-to)387-393
Number of pages7
JournalJournal of Pediatric Surgery
Volume18
Issue number4
DOIs
StatePublished - Jan 1 1983
Externally publishedYes

Keywords

  • Choledochal cyst
  • antenatal ultrasonography

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Howell, C. G., Templeton, J. M., Weiner, S., Glassman, M., Betts, J. M., & Witzleben, C. L. (1983). Antenatal diagnosis and early surgery for choledochal cyst. Journal of Pediatric Surgery, 18(4), 387-393. https://doi.org/10.1016/S0022-3468(83)80187-0