Transient abdominal pain, baby girl discovered to have rare disease

Moonlight DNUM_BEZBCZCABI 10:47

(Baonghean) - Choledochal cyst is a rare disease in children with a rate of 1/100,000 - 1/1,500,000 and women are more affected than men (ratio 4:1). If the patient is not detected and treated promptly, it can lead to gallstones, bile duct obstruction and dangerous complications related to the liver and bile.

On November 27, 2018, Vinh International Hospital successfully performed laparoscopic surgery to remove a cyst from the common bile duct, gallbladder, and connect the bile and intestines to a 10-year-old girl in Hoang Mai town (Nghe An).

LTTT, 10 years old, in Quynh Vinh, Hoang Mai town (Nghe An) was admitted to Vinh International Hospital with epigastric pain, accompanied by nausea. Before that, the child often had transient abdominal pain when eating and drinking, although he had been examined in many places but could not find the cause. After being examined clinically and tested by doctors: liver function, ultrasound, magnetic resonance imaging (MRI) of the abdomen, it was determined that T had a common bile duct cyst measuring 74 x 46 mm (type IC).

Các bác sỹ Bệnh viện Quốc tế Vinh thực hiện phẫu thuật nang ống mật.  Ảnh:  Kim Chung
Doctors at Vinh International Hospital perform surgery on a bile duct cyst. Photo: Kim Chung

After consultation, the patient was indicated for laparoscopic surgery to remove the common bile duct cyst, gallbladder and restore biliary circulation using the Roux-en-Y choleenteric anastomosis method.

The dissection of the choledochal cyst was difficult because it involved important components of the hepatic pedicle (duodenum, hepatic artery, portal vein). The surgery lasted more than 3 hours and ended successfully. After 7 days of post-operative care and treatment, baby T fully recovered and was discharged from the hospital.

Hình ảnh chụp cộng hưởng từ (MRI) ổ bụng. Ảnh: Kim Chung
Magnetic resonance imaging (MRI) of the abdomen. Photo: Kim Chung

According to Dr. Tran Viet Hung - Department of Surgery, Vinh International Hospital, choledochal cyst is a congenital spherical or rhomboid dilatation of the bile ducts in the liver, outside the liver or both, without primary obstruction of the choledochal cyst. Choledochal cysts are more common in Asia than in Western countries. According to the TODANI classification (1977), choledochal cysts include 5 types: I, II, III, IV, V; in which, in children, types I and IV account for 95%.

The disease is often difficult to detect because the symptoms are vague. Families need to be alert if the child has abdominal pain, accompanied by vomiting, and may have fever or jaundice. Choledochal cysts require early surgery at any age because of their dangerous complications.

Hình ảnh nang ống mật chủ sau phẫu thuật. Ảnh: Kim Chung
Image of common bile duct cyst after surgery. Photo: Kim Chung

“Choledochal cyst is a rare disease in children with a rate of 1/100,000 -1/1,500,000 and more women than men (ratio 4:1). If the patient is not detected and treated promptly, it can lead to gallstones, biliary obstruction and more dangerously, it can lead to cirrhosis, complications such as acute pancreatitis, acute cholangitis causing biliary bleeding, cyst rupture causing peritonitis, biliary tract cancer...

Therefore, when children show signs of severe abdominal pain, abdominal pain above the navel, pain of unknown cause, parents should not be subjective but take their children to medical facilities for examination and treatment. Cases of intestinal shunts need to be monitored periodically: 1, 3, 6 months after surgery. After that, once a year until the child is 15 years old, and must be dewormed periodically every 6 months" - Doctor Tran Viet Hung recommends.

Laparoscopic surgery to remove choledochal cysts is one of the difficult techniques that Vinh International Hospital has successfully performed; it has affirmed the solid expertise of the hospital's medical team in carrying out the mission of community health care./.

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