IVA型胆总管囊肿伴胆囊重复1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports Pub Date : 2025-08-25 DOI:10.1016/j.epsc.2025.103096

Saalim Nazki , Saswati Behera , Akshat Sudhanshu

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引用次数: 0

摘要

背景：胆囊复制是一种罕见的先天性异常，其与胆总管囊肿共存是非常罕见的。病例1:7岁女性，反复出现右上腹疼痛数月。实验室检查显示血清AST升高（142 IU/L）（正常范围8-33 IU/L）和ALT升高（158 IU/L）（正常范围4-36 IU/L），碱性磷酸酶轻度升高；胆红素水平在正常范围内。腹部超声（USG）显示胆总管扩张，磁共振胆管胰胆管造影（MRCP）证实IVA型胆总管囊肿。计划行腹腔镜囊肿切除并肝十二指肠切开术。术中发现一V型复制肝内双叶胆囊，单根囊性动脉和单根囊性导管（向上分叉以排出复制的胆囊叶）汇入总胆管。切除两个胆囊，并行肝十二指肠切开术。组织病理学证实胆囊复制伴慢性炎症改变，无发育不良。结论全膀胱重复是一种罕见的先天性异常，术前影像学检查难以发现，尤其是胆总管囊肿等复杂的胆道异常。

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Type IVA choledochal cyst with gallbladder duplication: a case report

Background

Gallbladder duplication is a rare congenital anomaly, and its coexistence with choledochal cysts is exceptionally uncommon.

Case

A 7-year-old female presented with recurrent right upper quadrant abdominal pain over several months. Laboratory investigations revealed elevated serum AST (142 IU/L) (normal range 8–33 IU/L) and ALT (158 IU/L) (normal range 4–36 IU/L), with mildly raised alkaline phosphatase; bilirubin levels were within normal limits. Abdominal ultrasonography (USG) demonstrated common bile duct dilation, and Magnetic Resonance Cholangiopancreatography (MRCP) confirmed a Type IVA choledochal cyst. Laparoscopic excision of the cyst with hepaticoduodenostomy was planned. Intraoperatively, a V shaped duplicated intrahepatic bilobed gallbladder was discovered, with a single cystic artery and a single cystic duct (bifurcated high up distally to drain the duplicated lobes of gall bladder) draining into the common bile duct. Both gallbladders were excised, and a hepaticoduodenostomy was performed. Histopathology confirmed gallbladder duplication with chronic inflammatory changes and no dysplasia.

Conclusion

Gallbladder duplication is a rare congenital anomaly that may not be identified on preoperative imaging, particularly in the setting of complex biliary anomalies like choledochal cyst.

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