Largest Biliary Cyst removed from a 5-year-old Girl

The largest paediatric biliary duct cyst (BDC) has been removed from a five-year-old girl by doctors at the JK Lon Hospital in the city of Jaipur.

The five-year-old girl was brought to the government-run hospital for the first time in the month of November. She was brought due to complications of colicky pain in the abdomen and vomiting frequently.

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‘A rare surgery was performed by Jaipur doctors on a five-year-old girl to remove the largest biliary duct cyst that measured about 23.5cm.’

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Doctors after a thorough examination found that she was suffering from a congenital bile duct anomaly.

"During the initial examination, a large lump was palpable on the right side of the abdomen. Tests revealed a huge dilatation of bile duct, which connects liver with intestines. Usually, the size of bile duct cyst is 2-5 mms. If its size is more than 10mm, it is termed as giant choledochal cyst (GCC),” said Dr Praveen Mathur, a senior professor and paediatric surgery unit head, who conducted the surgery.

The surgery was performed on the 20th November. BDC or choledochal cyst and the connecting liver with intestines were removed during surgery.

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The rare surgery performed could lead to complications such as bursting of the cyst or even development of cancer.

Doctors’ challenge was to protect the cyst from bursting, as it contained thousands of parasites and toxic fluids and if leaked into the liver could cause severe reactions and can form more cysts that could eventually kill the patient.

Only about 56 cases of GCC are reported around the world and the largest was reported in 2016 in Canada, which measured 17mm. However, the five-year-old had the largest paediatric GCC that measured 23.5cm, explained Dr. Mathur.

Dr Ashok Gupta, superintendent of JK Lon Hospital said that girl is doing fine and is recovering after the surgery and would be discharged from the hospital very soon.

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What is a Choledochal Cyst?

Choledochal Cyst, a congenital abnormality of the bile duct, which causes abnormal enlargement of the bile duct and different types of cysts are formed depending on the location and type of enlargement.

Most of the cysts are formed during childhood due to a reduction in the drainage of bile in patients with jaundice. Some patients can even develop repeated attacks of pancreatitis.

The cyst can be removed only by surgery, where the abnormal segment of the bile duct is removed and the small intestine is then raised to the bile duct and is sutured to the normal bile duct. Therefore, the bile secretions can route back into the intestine.

Reference:

Diagnosis and treatment of Choledochal Cyst

(http://www.surgery.usc.edu/divisions/tumor/pancreasdiseases/web%20pages/BILIARY%20SYSTEM/choledochal%20cyst.html )

Source-Medindia