• Advances in pediatric surgery
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• v.5 no.2
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• pp.126-129
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• 1999

A 6 and a half year-old girl developed recurrent cholangitis following hepatic portoenterostomy for biliary atresia. Computed tomogram showed an ovoid cyst ($4.5{\times}4.0$ cm in size) in the left hepatic lobe and another tubular dilatation ($2.0{\times}0.8$ cm in size) in the right hepatic lobe. Percutaneous transhepatic cholangiodrainage(PTCD) and cystogram showed an ovoid cyst in the left hepatic lobe (Tsuchida type A), measuring $6.6{\times}5.0$ cm in size. Following drainage and administration of parenteral antibiotics she became afebrile and anicteric. However she continued to drain 45-150 cc of bile per day via the tube over the next 2 weeks. The patient successfully underwent intrahepatic cystojejunostomy with intraoperative ultrasonographic guidance. This case illustrates relapsing cholangitis caused by Tsuchida type A intrahepatic cyst, successfully managed with PTCD followed by an internal drainage procedure.

• Journal of Veterinary Clinics
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• v.38 no.6
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• pp.295-298
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• 2021

A 1-year-old spayed female Scottish Fold cat presented with a 1.5-month history of vomiting, intermittent dyspnea, and abdominal distention. Radiographic, ultrasonographic, and computed tomographic examinations suggested a tentative diagnosis of a fluid-containing cystic mass with an internal septum. The mass was surgically removed. Histological examinations revealed that the mass was a non-neoplastic hepatic cyst. The patient had no recurrence of the cystic structure but died of acute renal failure 5 years after the surgery. This report describes the unusual case of a giant hepatic cyst with clinical signs that resolved after mass removal.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.186-191
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• 2005

A 10-year-old-girl was referred to our hospital due to abdominal pain. She underwent Roux-en-Y cystojejunostomy for a choledochal cyst at another hospital at the age of 3 months. Abdominal ultrasonography (USG) and computed tomography (CT) showed type I choledochal cyst and multiple gallbladder stones. Because of severe inflammation and adhesion, partial resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy was performed. Two and one half years later, intermittent abdominal pain, fever, nausea and vomiting occured. Abdominal CT scan showed a polypoid nodular lesion in the remnant of the choledochal cyst and probable metastasis at segment 7 of the liver. The duodenum was obstructed by the mass. Liver biopsy revealed moderately differentiated adenocarcinoma. A palliative gastrojejunostomy was performed to relieve duodenal obstruction. She died of hepatic insufficiency 4 months later.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.360-365
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• 2022

A 15-year-old spayed female Yorkshire Terrier was presented to our hospital with a history of anorexia, depression and abdominal pain. Diagnostic procedures including blood test, radiography and ultrasonography were performed. Abdominal ultrasonography revealed multiple hypoechoic cysts in the left lobe of the liver. Over time, the cysts increased in size and became more echogenic. Four days later, the rupture of the largest cyst was suspected, and hepatic abscesses with bacteria were confirmed by aspiration of the cyst. Despite surgical resection of the abscessed liver lobe, antibiotic administration, and supportive therapy, the dog died 9 days after presentation to the hospital and 4 days after the surgical procedure. The present case report described the overall diagnostic and therapeutic approaches for liver abscesses in a dog.

• The Korean Journal of Nuclear Medicine
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• v.21 no.2
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• pp.191-197
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• 1987

39 patients with focal hepatic lesions were evaluated by $^{99m}Tc-RBC$ liver scan. The diagnosis of focal hepatic lesions were made by percutaneous needle biopsy, angiography, surgery, or clinical courses. Thses diagnoses included 24 cases of hemangioma, 7 hepatomas, 6 metastatic disease, 1 abscess, and 1 cyst. 19 hemangiomas showed focal hot activity on delayed static planar images. 3 small deep seated hemangiomas were diagnosed by SPECT that would have been missed by planar images alone. 2 large hemangiomas had no radioisotope uptake within the lesions on delayed images and at surgery cavernous hemangioma with thrombosis, calcification, and fibrosis were found. For hepatic hemangiomas in our series, the sensitivity was 91.7% and the specificity was 100%. The remaining 15 patients including hepatomas, metastatic lesions, cyst and abscess showed cold defect on delayed blood pool images. It is concluded that $^{99m}Tc-RBC$ liver scan should be the choice of primary diagnostic procecure for clinically suspected hepatic hemangioma since it's inexpensive, non-invasive, and readly available.

• Parasites, Hosts and Diseases
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• v.33 no.2
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• pp.125-130
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• 1995

A 38-year old man visited a private clinic complaining of epigastric discomfort for 2 months A huge hepatic cyst was found by sonography and computerized tomography. An exploratory Laparotomy was performed under the impression of hydatid disease. The cyst was successfully removed. A lot of living protoscolices of Echinocucur Sranulosus were found from the cystic fluid under light microscopy. During the operation, however. the cyst was accidentally ruptured and the cystic fluid spilled out. The patient was medicated with albendazole, and had been well without any signs of anaphylaxis or recurrence for 1 year follow-up period. He had been in Saudi Arabia for 3 years. This is the 16th case of hydatid disease reported in Korea and a case without immediate complication in spite of rupture of the cyst.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.315-316
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• 2023

• Advances in pediatric surgery
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• v.14 no.2
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• pp.178-182
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• 2008

Forme fruste choledochal cyst (FFCC) is one of the diverse types of choledochal cyst with little or no dilatation of the extrahepatic bile duct (EHBD). It is considered that FFCC has to do with the pancreatobiliary malunion (PBM). In children, 3 to 6 millimeters of EHBD is assumed to be normal. Even though there is no clear-cut definition, FFCC is likely to be associated with bile duct dilatation less than 10 millimeters. Almost all cases have PBMs and symptoms of the pancreatitis or cholangitis. We experienced a case of FFCC in a 4-year-old boy. His EHBD measures 10 mm diameter. He had symptoms of pancreatitis and elevated hepatic transaminases. The pancreatobiliary common channel was 28 millimeters. He underwent EHBD resection and Roux-en-Y hepaticojejunostomy and was discharged with no specific complications.

• Advances in pediatric surgery
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• v.9 no.2
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• pp.81-88
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• 2003

Congenital dilatation of the common bile duct (choledochal cyst) is an uncommon disease. Although the etiology is unknown yet, various theories such as distal obstruction of the common bile duct, congenital weakness of the duct and anomalous union of the pancreaticobiliary duct have been offered to explain the occurrence of choledochal cyst. Thirty - six cases of choledochal cyst over 22 years were analyzed clinically and classified according to Todani's classification and Kimura's anomalous union of pancreaticobiliary duct type. Todani type 1 consisted with 22 cases which were subdivided into 19 cases of type Ia, 1 case of type Ib and 2 of type Ic. Type IVa consisted with 14 cases including one case of Caroli's disease. There were 25 type BP cases and 10 type PB cases and 1 normal pancreatobiliary junction. Serum alkaline phosphatase was increased significantly in almost all cases. Seven patients (19.4%) had associated congenital anomalies such as double gallbladder, left - sided gallbladder, common bile duct web, biliary atresia, accessory hepatic duct, heterotopic pancreas, cleft lip and 2 cases of intestinal malrotation. All patients underwent cyst excision and Roux - en - Y hepaticojejunostomy and cholecystectomy. There was one death due to methicillin resistant Staphylococcus aureus sepsis.

• Advances in pediatric surgery
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• v.4 no.2
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• pp.156-162
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• 1998

Choledochal cyst is rare in the western countries, but common in oriental countries. Complicatioins include ascending cholangitis, recurrent pancreatities, progressive biliary cirrhosis, portal hypertension, stone formation and later malignant transformation. Bile peritonitis secondary to rupture is one of the rarest complications, with an incidence of 1.8 % to 18 %. The anomalous arrangement of the pancreatobiliary ductal system with a long common channel may cause inflammation leading to perforation of the cyst. The authors found 4 cases (14.2 %) of bile peritonitis among 28 cases of choledochal cyst treated from Jan. 1983 to Jan. 1998. The patients ages ranged from 6 months to 3 years and three were female. The perforation sites were located on the common bile duct at its junction with the cystic duct in 2 cases, the distal cyst wall in 1 case and the left hepatic duct at its junction with cyst in 1 case. The types of choledochal cysts by Todani's classification were Type IVa in 3 cases and type I in 1 case. By the new Komi's classification utilizing operative cholangiogram there were 2 cases of Type Ia, 1 case of type IIb and 1 case of type III. One stage cyst excision and hepaticojejunostomy(Roux-en Y type) was done in 3 cases, and two staged operation in 1 case. All patients had an uneventful course postoperatively. The average day of discharge was 9.8th postoperatively. In conclusion, primary excision of the choledochal cyst and biliary reconstruction is a safe and effective treatment of ruptured choledochal cyst in infants.