Type I Choledochal Cyst a Case Presentation

Choledochal cysts are cysts of the biliary tree of varying location and quantity with the majority being categorized as Type I showing a fusiform dilation of the common bile duct. They affect 1:100,000 to 1:150,000 individuals in the Western world and are usually diagnosed on abdominal CT or US when looking for a source of right upper quadrant pain. Types I and IV choledochal cysts have an increased likelihood of transforming into cholangiocarcinoma and because of this must be caught early to allow total cyst excision followed by a Roux-en-Y hepatojejunostomy. Following total cyst removal, malignancy is seen in 0.7-6% of patients and for this reason they must be followed up annually for liver enzyme monitoring. The case described here is that of a 43 year old Hispanic male who presented with epigastric pain and was found to have a Type I choledochal cyst on abdominal CT. A brief discussion of presentation, management, and treatment for choledochal cysts will follow.