A Case of Choledchocele Associated with a Gall Stone Trapped in the Cyst

Shin Oguma, Yutaka Okubo, Shingo Matsuura*, Noriyuki Iwama¹⁾

Department of Surgery and Department of Internal Medicine*, Furukawa Minshu Hospital
Department of Pathology, Saka General Hospital¹

We presented a rare case of choledochocele with a cystic stone. A 59 year-old woman was admitted to Furukawa Minshu Hospital with epigastric pain. She underwent surgery because laboratory findings showed evidence of cholangitis. Intraoperative cholangiography revealed a choledochocele approximately 1.5 cm in diameter which contained a stone approximately 8 mm in diameter consisting of bilirubin calcium. However no stone was found in the gall bladder nor in the intra or extra bile duct. Operative findings also showed that our case was type "B" according to Scholz's classification. Of 48 cases reported in the Japanese literature, there were three rare cases like ours in which there was a stone only within the cyst. On the other hand, in our case pathological examination showed mild inflammatory changes in the cyst, which was covered with duodenal mucosa. In our patient's operation, an incision was made in the cyst wall after sphincterotomy. Incision of the wall was thought to be adequate surgical treatment for choledochocele, because cases of choledochocele with carcinoma are extremely rare compared with other types of choledochal cysts.

Key words
choledochal cyst, choledochocele

Reprint requests
Shin Oguma Department of Surgery, Saka General Hospital
16-5 Nishikicho, Shiogama, 985 JAPAN

Accepted
May 9, 1990

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