Type III Choledochal Cyst Presenting as Recurrent Pancreatitis in Young Child, Magnetic Resonance Findings Suggesting Etiology Prior to Endoscopy - Abstract
A type III choledochal cyst (choledochocele) is a rare lesion affecting the distal common bile duct and pancreato-biliary junction, which is consistently described in the literature as a cystic lesion involving the duodenal wall at the ampulla and involving these structures. The exact etiology is unknown with some hypothesizing that this is a congenital anomaly while others supporting that a choledochocele is acquired. This case presents a 7 year-old male child with recurrent pancreatitis and a choledochocele having a varied appearance over time on magnetic resonance cholangiopancreatography (MRCP). Patient was amply imaged, a choledochocele due to an ampullary obstruction was suspected and he underwent a therapeutic endoscopic intervention (ERCP) with resulting complete resolution of his symptoms. This
case supports the hypothesis that these lesions are actually acquired and related to obstruction within the distal ampulla. Lastly, this case highlights the diagnostic utility of MRCP in the pediatric patient and ERCP as a therapeutic option for these lesions.