Yu-Hsien Lee1, Lung-Huang Lin1,2* and Ynug-Chuan Chen1,2*
1Department of Pediatrics, Cathay General Hospital, Taiwan
2Department of Pediatrics, School of Medicine, Fu Jen Catholic University, Taiwan
bile duct anomaly, usually appear from the first year of life. The classic triad comprises intermittent abdominal pain, jaundice, and a right upper quadrant abdominal mass. However, this trial can be found only in a few patients. Herein, we describe the case of a young girl who experienced severe right upper quadrant abdominal pain that was diagnosed as choledochal-cyst-related biliary colic, for which she underwent surgery. Case Report: A 10-year-old girl presented to Cathay General Hospital with sudden and severe epigastric pain lasting for 2 days. Additionally, her complaints included nausea and nonbilious vomiting. Laboratory data revealed total and direct bilirubin levels to be 1.1 and 0.6 mg/dL, respectively. The patient’s condition had previously been diagnosed as gastrospasm by local doctors; however, the symptoms were persistent and even progressive. A diagnosis for type 1C choledochal cyst with biliary colic associated with distal common bile duct stone was made through abdominal computed tomography, sonography and magnetic resonance cholangiopancreatography. The patient was surgically treated through cholecystectomy, choledochal cyst excision, and Roux-en-Y hepaticojejunostomy. The patient recovered well without recurrence. Conclusion: Differential diagnoses must be considered in cases involving persistent gastrospasm. Although most choledochal cysts are diagnosed at infancy, they can be diagnosed in older children as well and usually present as abdominal pain due to accompanying pancreatitis. However, choledochal cysts with abdominal pain due to biliary colic can also be one of the possible differential diagnoses for acute abdominal pain in children or adolescents.
Choledochal cyst; Biliary colic; Abdominal pain; CBD stone
Lee Y-H, Lin L-H, Chen Y-C. A Rare Case of Sudden and Severe Abdominal Pain in Children. Clin Surg. 2020; 5: 2751..