EN
TÜRKÇE
Poster - 18
Choledochocele in Children Mistaken for Duodenal Duplication: Two Case Reports on Diagnosis and Treatment
S Fkaier*, S Ben Youssef**, S Sfar**, S Mani**, BF Meriem**, L Sahnoun**, M Mekki**
*Fattouma Bourguiba Hospital Monastir Tunisia
**Department of Pediatric Surgery, Monastir University Hospital, Tunisia
Introduction:
Choledochocele, or Type III choledochal cyst, is the rarest form of choledochal cyst, particularly in the pediatric population, accounting for only 1.5% of cases. Its clinical and radiological resemblance to duodenal duplication makes preoperative diagnosis challenging. Histopathological examination remains the definitive diagnostic tool.
Case Report:
A five-year-old girl with recurrent urinary tract infections underwent imaging, revealing an intra-abdominal cyst suspected to be duodenal duplication. Laparoscopic exploration followed by laparotomy identified an intraluminal duodenal mass communicating with the bile duct, confirming choledochocele. A transduodenal marsupialization was performed. After nine years of follow-up, the patient remained asymptomatic.
A five-year-old boy presented with recurrent abdominal pain and vomiting. Imaging suggested duodenal duplication, leading to surgical intervention. Intraoperative findings revealed a cystic dilation in the duodenum filled with biliary fluid and lithiasis. The cyst was flattened, and a partial excision was performed. Histopathological examination confirmed choledochocele. The patient recovered well postoperatively.
Conclusion:
Choledochocele remains a diagnostic challenge due to its overlap with duodenal duplication. Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for diagnosis and treatment, though its use in pediatric cases is limited. While surgical management remains the primary approach, increasing awareness of choledochocele can facilitate early diagnosis and the adoption of less invasive endoscopic techniques when appropriate.