A Case with Pancreaticobiliary Maljunction who has been Observed as Having Choledochal Cyst : Choledochal Cyst or Biliary Atresia ?

Abstract

A female patient was diagnosed as having obstructive jaundice and underwent choledochocystoduodenostomy at the age of 45 days. Macroscopic biliary cirrhosis was observed. Liver biopsy and operative cholangiography were not performed. Postoperatively, she was free from jaundice but had ascending cholangitis frequently. When she was 9 years old, she was diagnosed as having portal hypertension and received detailed examinations. Cholangiography revealed pancreaticobiliary maljunction, the presence of distal bile duct and an abnormal finding of intrahepatic bile duct. The presence of remnant choledochal cyst was not clearly identified. Liver biopsy revealed the finding of mild hepatic fibrosis. It was impossible to determine whether she had choledochal cyst or biliary atresia.