Abstract:

Biliary tract cysts, also known as congenital choledochal cysts (congenital bile dilatation), mainly manifest as the dilatation of the extrahepatic bile duct. Its global incidence is 1/150 000 – 1/100 000, but it may be as high as 1/1 000 in Asians. In addition, the incidence rate shows that women are dominant, with a female to male ratio of 3:1 to 4:1. Biliary tract cysts often appears in infants and can be diagnosed occasionally, or when it causes biliary pancreatitis accompanied by abdominal pain, jaundice, or even an enlarged liver ^[1]. In recent years, the incidence of the disease has also increased in China. This paper reports a case of Ⅳb congenital choledochal cyst with persistent abdominal pain, elevated blood amylase, and other acute pancreatitis symptom as the first symptoms. The patient was diagnosed as Ⅳb congenital choledochal cyst by imaging examination. When the symptoms of pancreatitis were relieved, the diseased part was removed by surgery, and the patient was cured and discharged. Clinicians should improve the understanding of relevant cases and their diagnosis and treatment to avoid misdiagnosis and treatment errors.

Key words:

Congenital choledochal cyst, Acute pancreatitis, Surgical treatment, Literature review

摘要：

胆道囊肿，也称为先天性胆总管囊肿（先天性胆汁扩张），主要表现为肝外胆管的扩张。它的全球发病率为1/150 000～1/100 000，但亚洲人的发病率高达1/1 000。此外，发病率显示女性占主导地位，女性与男性的比例为3：1～4：1。胆道囊肿经常出现在婴儿身上，可以偶然诊断出来，或者当它导致胆汁性胰腺炎并伴有腹痛、黄疸甚至肝脏肿大时，才能经诊断发现^［1］。且近些年来，中国的该病发病率也有所升高。本文报道了暨南大学附属第一医院消化内科2022年10月27日收治的1例Ⅳb型先天性胆总管囊肿患者，以持续性腹痛、血淀粉酶升高等急性胰腺炎（AP）表现为首发症状，影像学检查诊断为Ⅳb型先天性胆总管囊肿，待胰腺炎症状缓解，行手术治疗切除病变部分后痊愈出院。临床医生应该提高对相关病例的认识和诊疗思路，避免出现误诊及治疗错误。

关键词:

先天性胆总管囊肿, 急性胰腺炎, 手术治疗, 文献复习