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Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4...

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Choledochal Cyst with Annular Pancreas
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Page 1: Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4 yrs Investigations: – Biochemistry: s. amylase, s.

Choledochal Cyst with Annular Pancreas

Page 2: Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4 yrs Investigations: – Biochemistry: s. amylase, s.

History

• 45 , Female• Recurrent pain in epigastric region x 3-4 yrs• Investigations:– Biochemistry: s. amylase, s. lipase , s. Alk.pho.

Elevated s/o acute mild pancreatitis, rest NAD– USG : dilated CBD with lower end tapering and

central IHBR– MRCP: type 1 choledochal cyst

Page 3: Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4 yrs Investigations: – Biochemistry: s. amylase, s.

Imaging

Page 4: Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4 yrs Investigations: – Biochemistry: s. amylase, s.

Exposure

Page 5: Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4 yrs Investigations: – Biochemistry: s. amylase, s.

Annular Pancreas

Annular pancreas

Liver

Duodenum

Page 6: Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4 yrs Investigations: – Biochemistry: s. amylase, s.

CDC Excision

Intrapancreatic excision

Intrapancreatic dissection

Page 7: Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4 yrs Investigations: – Biochemistry: s. amylase, s.

Upper margin & Reconst.

RYHJ

Page 8: Choledochal Cyst with Annular Pancreas. History 45, Female Recurrent pain in epigastric region x 3-4 yrs Investigations: – Biochemistry: s. amylase, s.

• Post –operative course uneventful.• Patient gained 6 kg wt. over 4 months.• Follow up till date is excellent course with no

gastric outlet obstructive symptoms


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