Open AccessA rare case of a common hepatic duct stricture secondary to an anteriorly crossing right hepatic artery in an infant
Author(s) -
Aureen Ruby DCunha,
Braj Kishore,
Isaac Tharu Varghese
Publication year - 2018
Publication title -
journal of indian association of pediatric surgeons
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.306
H-Index - 17
eISSN - 1998-3891
pISSN - 0971-9261
DOI - 10.4103/jiaps.jiaps_199_17
Subject(s) - medicine , common hepatic duct , choledochal cysts , anastomosis , left hepatic duct , obstructive jaundice , common bile duct , artery , bile duct , duct (anatomy) , radiology , surgery , anatomy , cyst
A 1-year-old male child presented with progressive jaundice. Investigations were suggestive of an obstructive pathology with a suspected choledochal cyst on imaging. Intraoperative cholangiogram demonstrated runoff of contrast from the cystic duct into the common bile duct with no opacification of the biliary system proximal to this. Intraoperatively, the right hepatic artery was found anteriorly crossing the common hepatic duct (CHD) causing extrinsic compression leading to complete obstruction. Following stricture excision and anastomosis of the dilated bulbous CHD to a Roux-en-Y jejunal loop, the child recovered completely. An anteriorly crossing right hepatic artery causing obstruction to the biliary duct is a rare occurrence, more so in infancy. An excision with a hepaticojejunostomy is straight forward and curative.