Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 28, 2012; 18(28): 3761-3764
Published online Jul 28, 2012. doi: 10.3748/wjg.v18.i28.3761
Computed tomography virtual endoscopy with angiographic imaging for the treatment of type IV-A choledochal cyst
Akihiko Tsuchida, Yuichi Nagakawa, Kazuhiko Kasuya, Bunso Kyo, Takahisa Ikeda, Yoshiaki Suzuki, Tatsuya Aoki, Takao Itoi
Akihiko Tsuchida, Yuichi Nagakawa, Kazuhiko Kasuya, Bunso Kyo, Takahisa Ikeda, Yoshiaki Suzuki, Tatsuya Aoki, Third Department of Surgery, Tokyo Medical University, Tokyo 160-0023, Japan
Takao Itoi, Fourth Department of Internal Medicine, Tokyo Medical University, Tokyo 160-0023, Japan
Author contributions: Tsuchida A, Nagakawa Y, Kasuya K and Suzuki Y performed the operation; Kyo B, Ikeda T and Itoi T contributed to the imaging processing and analysis; Tsuchida A and Aoki T wrote the paper.
Correspondence to: Akihiko Tsuchida, Professor, MD, PhD, Third Department of Surgery, Tokyo Medical University, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. akihikot@tokyo-med.ac.jp
Telephone: +81-3-33426111 Fax: +81-3-33404575
Received: December 2, 2010
Revised: January 18, 2011
Accepted: May 12, 2012
Published online: July 28, 2012
Abstract

Type IV-A choledochal cysts (CCs) are a congenital biliary anomaly which involve dilatation of the extrahepatic and intrahepatic bile ducts. We present the case of a 30-year-old woman with type IV-A CC, on whom three-dimensional computed tomography (3D CT) and virtual endoscopy were performed. 3D CT revealed partial dilatation in the posterior branch of the intrahepatic bile duct and a relative stricture between it and the extrahepatic bile duct. Virtual endoscopy showed that this stricture was membrane-like and separated from the surrounding blood vessels. Based on these image findings, complete cyst resection, bile duct plasty for the stricture, and hepaticojejunostomy were safely performed. To the best of our knowledge, there are no reports of imaging by virtual endoscopy of the biliary tract which show the surrounding blood vessels running along the bile duct.

Keywords: Choledochal cyst, Bile duct dilatation, Computed tomography, Virtual endoscopy, Bile duct plasty