TYPES OF CHOLEDOCHAL CYSTS
Choledochal cysts are congenital conditions involving cystic
dilatation of bile ducts.
They were classified into 5 types by Todani in 1977.
Type I Choledochal Cysts - These are the most common, representing 80-90% of the lesions. Type I cysts are dilatations of the entire common hepatic and common bile ducts or of segments of each. They can be saccular or fusiform in configuration. Type I cysts can be divided into 3 subclassifications, including type IA cysts, which are typically saccular and involve all or a major portion of the extrahepatic bile duct (common hepatic duct plus common bile duct).
Type II Choledochal Cysts - These are relatively isolated protrusions or diverticula that project from the common bile duct wall. They may be either sessile or connected to the common bile duct by a narrow stalk.
Type III Choledochal Cysts - Also called choledochoceles, these are found in the intraduodenal portion of the common bile duct.
Type IV A Cysts - These are characterized by multiple dilatations of the intrahepatic and extrahepatic biliary tree. Most frequently, a large, solitary cyst of the extrahepatic duct is accompanied by multiple cysts of the intrahepatic ducts.
Type IVB choledochal cysts - These consist of multiple dilatations that involve only the extrahepatic bile duct.
Type V Choledochal Cysts - These are defined by dilatation of the intrahepatic biliary radicles. Often, numerous cysts are present with interposed strictures that predispose the patient to intrahepatic stone formation, obstruction, and cholangitis. The cysts are typically found in both hepatic lobes. Occasionally, unilobar disease is found and most frequently involves the left lobe.
Ravi
MRI technologist
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