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26.Pediatric Choledochal Cyst, Symptoms/Signs, Management and Outcome, Our Experience
Muhammad Ramzan Bhutta1, Abid Hameed Sheikh2, Muhammad Siddiq1 and Soofia Mustafa1
ABSTRACT
Objective: To discuss the symptoms/signs, investigations and management of children presented with choledochal cysts (CC)
Study Design: Retrospective study
Place and Duration of Study: This study was conducted at the Department of Pediatric and Neonatal Surgery Bahawal Victoria Hospital from September 2014 to September 2022.
Materials and Methods: 63 patients under 16 year of age with diagnosis of choledochal cyst were studied. For statistical analysis we divided patients into two groups , <1 year of age and above 1 year to 16 year of age. Mass right hypochondrium, jaundice, painabdomen, nausea /vomiting with raised alkaline phosphatase level , and imaging USG/CT Scan abdomen finding favouring choledochal cyst were the inclusion criteria.
Results: Out og 63 children studied, 17(26.9%) were infants (<1 year) and 46 (73.1%) were older than one year of age. Seventeen months was the mean age with range from 21 days to 16 years. thirty five (55.9%) patients were female and 28 (44.1%) male. Type-I choledochal cyst 59 patients, Type-IV , 3 patients and type V( caroli disease )1 patient.as regards symptoms/signs(S/S) jaundice in 13(76.5%), and acholic stool in 9 (59%) patients among <1 year , while second group(>1 year) presented with pain abdomen 38 (83%), vomiting 35(77%), fever18 (43%) and acute pancreatitis 12(27%). Mass right hypochondrium23 (50%)was another main presenting feature in older age. post operative complications were noted in 7 (11.7%) patients which were managed.
Conclusion: The symptom/signs of Choledochal cysts vary according to the patient age and operative excision is the main stay of treatment. So early detection and management will prevent the rate of complications.
Key Words: Choledochal cyst, symptoms/signs, Surgical outcome