Abstract
A 20-year-old male was admitted to Toyota Memorial Hospital complaining of epigastric pain and nausea on August 1, 1989. Ultrasonogram and plain-CT revealed giant cystic lesions in the liver. ERCP showed enormously dilated intrahepatic bile ducts, and celiac angiographyy disclosed several arteries vertically branching from the compressed hepatic arteries. PTC showed cystic dilation of the common bile duct, hepatic ducts, and intrahepatic bile ducts. In the dilated hepatic ducts, several mucosal-tag like structures were found by subsequently performed PTCS. Biopsy specimens showed no malignancy. Total choledochotomy with cystectomy was performed and histological examination revealed fibrous thickening of the ductal wall and the mucosal-tag like structures containing arteriolles. Of 581 cases of congenital choledochal cyst reported in the Japanese literature from 1980 to January 1991, this is the first report of the choledochal cyst with mucosal-tag like structures. We concluded that PTCS and biopsy would be necessary for the further examination of congenital choledochal cyst.
