EC Paediatrics

Introduction: Choledocele, first reported by Wheeler in 1940, is classified as type 3 of congenital biliary dilatation according to Todani's classification. It is considered the rarest form. We report a case of choledocele in a 10-year-old boy.

Observation: A 10-year-old boy with no history of pain or jaundice was admitted with acute pancreatitis. Clinical examination revealed no palpable mass. Radiological findings revealed an intraduodenal cystic image with a digestive wall, initially suggestive of a digestive duplication. However, given the location of the lesion, the hypothesis of congenital dilatation of the main bile duct (DCVBP) was also considered. After treatment of the pancreatitis, surgical exploration via duodenotomy confirmed the diagnosis of choledochocele. The operation revealed a cystic formation on the inner wall of the second duodenum, centred by a bile-flowing orifice. Treatment consisted of a simple incision of the choledocele. A biliodigestive bypass was not considered necessary due to the low risk of degeneration associated with this type of DCVBP. Postoperative follow-up was straightforward. After 6 months, the patient was asymptomatic and his pancreatic work-up was normal.

Conclusion: This rare case of choledocele illustrates the diagnostic and therapeutic challenges of this pathology, underlining the importance of an individualized approach. Treatment by simple incision proved effective, but long-term follow-up remains essential to monitor possible late complications.

 Keywords: Congenital Dilatation of the Bile Ducts; Choledocele

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