Open AccessA misdiagnosis of choledochal cyst type IB and recommendation to use gold-standard imaging techniques: a case report
Author(s) -
Arsalan Hyder,
Nitik Sharma,
Farhan Ali,
Hina Sadiq,
Kashif Ali,
Hittik Kumar
Publication year - 2022
Publication title -
journal of the pakistan medical association
Language(s) - English
Resource type - Journals
ISSN - 0030-9982
DOI - 10.47391/jpma.4855
Subject(s) - medicine , magnetic resonance cholangiopancreatography , choledochal cysts , magnetic resonance imaging , radiology , abdominal pain , cyst , jaundice , surgery , endoscopic retrograde cholangiopancreatography , pancreatitis
A choledochal cyst (CC) is a rare congenital dilation of the biliary ductal system that can cause troublesome complications when left untreated. CC in children classically manifests as a rare triad of the right upper quadrant mass, jaundice, and abdominal pain. Here, we report the case of an eight-year-old boy seen in Paediatric Unit I of Dr Ruth K. M. Pfau Civil Hospital Karachi, Pakistan, on October 9, 2019, who was initially misdiagnosed for liver abscess due to the non-specific symptoms and managed appropriately with antibiotics, which failed to improve the symptoms. Moreover, a hydatid cyst was considered based on ultrasonography (USG) which was later ruled out by the negative serology. A definitive diagnosis of CC was established on magnetic resonance cholangiopancreatography (MRCP). In resource-limited countries, USG is always the first line screening tool for biliary duct abnormalities which in some cases is comprehensibly enough for the diagnosis of a rare entity like CC, thus requiring a highly specific imaging test like MRCP to be performed to devise an effective treatment and surgical plan.