March 2011

Abnormal common bile duct and peritoneal fluid

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Clinical information

Acute abdominal pain and signs of peritonitis

Ultrasound Images & Clips

Abnormal common bile duct and peritoneal fluid

Another image of the abnormal common bile duct and peritoneal fluid

videoclip of the abnormal common bile duct

Another videoclip of the abnormal common bile duct

Normal flow in the portal vein, but no flow in the diatated common bile duct

Transverse image of the comon bile duct

Another transverse image of the abnormal common bile duct. There is a normal gallbladder

There is a lot of peritoneal fluid

Conclusion

Because we found only an abnormal wide common bile duct and no dilatated intrahepatic ducts and no dilatated gallbladder we concluded that there was probably a choledochal cyst. We could find no other explanation for the peritoneal fluid. A puncture of the fluid showed that it was bilious fluid. Because a ruptured choledochal cyst was suspected the patient was referred to a pediatric university hospital where the patient was operated. The final diagnosis was a ruptured choledochal cyst.

References
Spontaneous rupture of extrahepatic choledochal cyst: two pediatric cases and literature review.
Arda IS, Tuzun M, Aliefendioglu D, Hicsonmez A.
Eur J Pediatr Surg. 2005 Oct;15(5):361-3. Review.

Spontaneous perforation of choledochal cyst: a study of 13 cases.
Ando K, Miyano T, Kohno S, Takamizawa S, Lane G.
Eur J Pediatr Surg. 1998 Feb;8(1):23-5.

Details

Sex: Female
Age: 1

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Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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