Congenital Choledochal Cyst: Report of a Case with Unusual Clinical Manifestation

先天性總膽管囊腫－不尋常臨床表徵之一例

鄭素珠(Su-Ju Cheng) ； 李鍾祥(Chung-Hsiang Lee) ； 陳秋江(Chiou-Chiang Chen)

《Acta Paediatrica Sinica》 16卷2期 (1975/06) Pp. 79-83

摘要

本文報告一個十五個月男孩的總膽管囊腫病例。腹部觸診，在肝臟的下方摸到一個邊緣不清的囊狀腫瘤，同時在左下腹部另摸到一個約5公分×4.5公分大的囊狀腫瘤，開刀時才發現此二個腫瘤事實上只是一個約20×15×6公分大的胡蘆狀總膽管囊腫。這個囊腫由總肝管的末端形成，延伸到腹腔後部十二指腸第三部分附近，更增加此先天性疾患之多形性特徵。此病例之診斷實費苦心，待開刀後才真相大白，經切除囊腫及Roux-en-Y總膽管空腸吻合術後，雖有傷口感染，經過良好出院。

並列摘要

A case of huge congenital choledochal cyst in a one year and three month old boy is reported. He was admitted to National Taiwan University Hospital in July 1974 for evaluation of two abdominal masses which had been found by his mother for nearly six months. Abdominal palpation disclosed a deep seated cystic mass of ill defined margin beneath the liver and another cystic mass measuring 5×4.5cm in size in the left lower abdomen. On laparotomy, the two masses turned out to be a single dumb-bell shaped choledochal cyst measuring 20×15×6cm in size, arising from distal common hepatic duct and extended to the retroperitoneal space of the third portion of the duodenum pushing the pancreas anteriorly and upward.. This congenital lesion gave the bizarre pattern of the cyst followed by Roux-en-Y choledochojejunostomy was performed successfully.