A misdiagnosis of choledochal cyst type IB and recommendation to use gold-standard imaging techniques: A case report | [Journal of Pakistan Medical Association • 2022]

Author(s):

1. Arsalan Hyder: Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

2. Nitik Sharma: Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

3. Farhan Ali: Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.

4. Hina Sadiq: Department of Paediatric Medicine, Dr. Ruth K.M Pfau Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan.

5. Kashif Ali: Department of Paediatric Medicine, Dr. Ruth K.M Pfau Civil Hospital, Dow University of Health Sciences, Karachi, Pakistan.

6. Hittik Kumar: Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

Abstract:

A choledochal cyst (CC) is a rare congenital dilation of the biliary ductal system that can cause troublesome complications when left untreated. CC in children classically manifests as a rare triad of the right upper quadrant mass, jaundice, and abdominal pain. Here, we report the case of an eight-year-old boy seen in Paediatric Unit I of Dr Ruth K. M. Pfau Civil Hospital Karachi, Pakistan, on October 9, 2019, who was initially misdiagnosed for liver abscess due to the non-specific symptoms and managed appropriately with antibiotics, which failed to improve the symptoms. Moreover, a hydatid cyst was considered based on ultrasonography (USG) which was later ruled out by the negative serology. A definitive diagnosis of CC was established on magnetic resonance cholangiopancreatography (MRCP). In resource-limited countries, USG is always the first line screening tool for biliary duct abnormalities which in some cases is comprehensibly enough for the diagnosis of a rare entity like CC, thus requiring a highly specific imaging test like MRCP to be performed to devise an effective treatment and surgical plan.

Page(s): 2137-2139

DOI: 10.47391/JPMA.4855

Published: Journal: Journal of Pakistan Medical Association, Volume: 72, Issue: 10, Year: 2022

Keywords:

pediatrics , diagnostic errors , choledochal cyst

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