Indian Journal of Nuclear Medicine
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Year : 2011  |  Volume : 26  |  Issue : 3  |  Page : 157-158

Spontaneously ruptured choledochal cyst: Rare diagnosis on hepatic scintigraphy

Department of Nuclear Medicine, Army Hospital Research and Referral, Delhi, India

Correspondence Address:
Suneel Chauhan
Resident Nuclear Medicine, Army Hospital Research and Referral, Delhi Cantt-10
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-3919.104001

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A 47-day-old female infant presented with congenital inguinal hernia, seizure on the 2 nd day of life, fever, progressive jaundice, acholic stools and distension of abdomen. She was suspected to have choledochal cyst with extrahepatic biliary atresia (EHBA) and referred for an Hepatobiliary Tc-99m iminodiacetic acid (HIDA) scan. On HIDA scan, a functional diagnosis of ruptured choledochal cyst was made which was not possible on anatomical imaging like ultrasound (USG)/computed tomography (CT) scan. This was supported thereafter by bilious aspirate on abdominal paracentesis. Immediate laparotomy with T-tube insertion was done. The child improved dramatically after the procedure. Biliary peritonitis secondary to cyst perforation or rupture is a rare complication reported to occur in 1-2% cases of choledochal cyst. Early diagnosis and management is the key to reduce the morbidity and mortality.

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