COLEDOCOCELE en adulto mayor: una causa inusual de pancreatitis aguda a repetición. Reporte de caso

Introduction

Choledochal cysts refer to the cystic dilation of a segment of the bile duct. They have an incidence of 1 in 100,000-150,000 individuals, being more common in women. Twenty percent are diagnosed in adulthood and may complicate various pancreatobiliary diseases, including recurrent acute pancreatitis. If left untreated, it may lead to significant complications in adulthood. This case emphasizes the need to consider anatomical causes in patients with pancreatitis of unclear etiology in order to improve diagnosis and management.

Case Report

A 69-year-old woman with a history of previous cholecystectomy and two episodes of non-alcoholic acute pancreatitis, presented with epigastric pain radiating in band, associated with vomiting and abdominal distension. The patient did not refer drug or alcohol consumption. Laboratory parameters revealed hyperamylasemia. Magnetic resonance cholangiopancreatography indicated cystic dilation of the distal common bile duct. Endoscopic sphincterotomy and unroofing of the choledochocele were performed under endoscopic retrograde cholangiopancreatography (ERCP), with complete clinical recovery.

Discussion and Conclusion

Choledochocele is an uncommon pathology in adults and difficult to suspect as the primary cause of recurrent acute pancreatitis. Treatment depends on its classification, with ERCP being the treatment of choice in this case. This approach allows resolution and prevents recurrence of complications and potential malignancy of the lesion.