Doença Cística das Vias Biliares do tipo IVa: Relato de Caso

Abstract

Cystic bile duct disease is a congenital anomaly that can affect the intra- and/or extrahepatic bile ducts. The classic triad presents as abdominal pain, jaundice, and abdominal mass. However, accurate diagnosis is difficult as this triad is present in only one third of patients, and also because laboratory changes are non-specific and can cause numerous hepatobiliary diseases. Imaging methods such as ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) are indicated for the early diagnosis of cysts to avoid possible complications, in addition to being useful in the surgical plan. The case report aims to analyze in detail the actions taken based on the clinical picture presented, through observation of the medical records and interviews with the patient. The clinical case describes an adult female patient, who presented with pain in the right hypochondrium, jaundice, nausea and vomiting. Initial examinations revealed hyperbilirubinemia, and the diagnostic approach included US Abdominal Tomography and Endoscopic Retrograde Cholangiopancreatography (ERCP), resulting in the diagnosis of chronic cholecystitis and cholelithiasis. After cholecystectomy, development of infected bilioma, treated with percutaneous traction and surgical intervention. Later, he developed cholangitis, which was caused by type IVa cystic disease of the bile ducts. He underwent combined biliary transfer and was discharged with referral for surgical referral. Therefore, the case report demonstrates the complexity of managing this condition and the importance of carrying out a thorough investigation to reach the correct diagnosis in order to provide the best possible treatment and avoid further complications.