Spontaneous rupture of choledochal cyst with pseudocyst formation—report on 2 cases and literature review


      Spontaneous rupture and subsequent bile peritonitis are rare complications of choledochal cysts. Of these complications, the formation of a biliary pseudocyst is an unusual form, and its preoperative diagnosis is difficult. In this report, we describe 2 cases showing spontaneous rupture with biliary pseudocyst formation. Inflammatory tissue surrounded those pseudocysts, one of which was adjacent to the perforation and the other formed in the transverse mesocolon apart from the biliary tract. These pseudocysts were removed by careful dissection, and single-stage cyst excision with biliary reconstruction was successfully performed in both cases.

      Index words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Iwai N.
        • Yanagihara J.
        • Tokiwa K.
        • et al.
        Congenital choledochal dilatation with emphasis on pathophysiology of the biliary tract.
        Ann Surg. 1992; 215: 27-30
        • Lilly J.R.
        Surgical jaundice in infancy.
        Ann Surg. 1977; 186: 549-558
        • Karrer F.M.
        • Hall R.J.
        • Stewart B.A.
        • et al.
        Congenital biliary tract disease.
        Surg Clin North Am. 1990; 70: 1403-1418
        • Hsu Y.C.
        • Lin T.Y.
        • Lee H.C.
        • et al.
        Congenital biliary tract dilatation in infancy and childhood—74 cases experience.
        Chang Gung Med J. 1994; 17: 301-308
        • Stringer M.D.
        • Dhawan A.
        • Davenport M.
        • et al.
        Choledochal cysts: lessons from a 20 year experience.
        Arch Dis Child. 1995; 73: 528-531
        • Ando K.
        • Miyano T.
        • Kohno S.
        • et al.
        Spontaneous perforation of choledochal cyst: a study of 13 cases.
        Eur J Pediatr Surg. 1998; 8: 23-25
        • Ando H.
        • Ito T.
        • Watanabe Y.
        • et al.
        Spontaneous perforation of choledochal cyst.
        J Am Coll Surg. 1995; 181: 125-128
        • Fumino S.
        • Tokiwa K.
        • Katoh T.
        • et al.
        New insight into bile flow dynamics in anomalous arrangement of the pancreaticobiliary duct.
        Br J Surg. 2002; 89: 865-869
        • Banani S.A.
        • Bahador A.
        • Nezakatgoo N.
        Idiopathic perforation of the extrahepatic bile duct in infancy: pathogenesis, diagnosis, and management.
        J Pediatr Surg. 1993; 28: 950-952
        • Hasegawa T.
        • Udatsu Y.
        • Kamiyama M.
        • et al.
        Does pancreatico-biliary maljunction play a role in spontaneous perforation of the bile duct in children?.
        Pediatr Surg Int. 2000; 16: 550-553
        • Treem W.R.
        • Hyams J.S.
        • McGowan G.S.
        • et al.
        Spontaneous rupture of a choledochal cyst: clues to diagnosis and etiology.
        J Pediatr Gastroenterol Nutr. 1991; 13: 301-306
        • Franga D.L.
        • Howell C.G.
        • Mellinger J.D.
        • et al.
        Single-stage reconstruction of perforated choledochal cyst: case report and review of the literature.
        Am Surg. 2005; 71: 398-401