A one-and-a-half year old boy comes to the emergency room with abdominal pain and jaundice. On examination, an abdominal mass is palpated. An ultrasound shows the presence of a common bile duct cyst. What therapeutic approach should we adopt?
The correct answer is 4. A common bile duct cyst is a congenital pathology that usually presents clinically beyond the neonatal period. It is appropriate to have a quality image that delimits the lesion in order to decide the surgical approach.
A percutaneous puncture for peritoneal lavage will be performed to verify that the cyst contains bile in order to leave a drainage to improve the abdominal pain.
An exploratory laparotomy will be indicated and a radical resection of the entire biliary tract will be performed to replace it with a loop of intestine.
A laparotomy will be indicated to drain the cyst and when the dilatation remits the drainage will be removed.
A cholangio-resonance will be performed to delimit the cyst and a laparotomy will be indicated for cyst resection and anastomosis of the biliary tract.
A HIDA gammagraphic study is necessary to delimit the cyst and to be able to perform percutaneous drainage safely.
A common bile duct cyst is a congenital pathology that usually presents clinically beyond the neonatal period. It is appropriate to have a quality image that delimits the lesion in order to decide the surgical approach.