A choledochal cyst type I was diagnosed in a 12-year-old boy in 1984. The
diagnosis was made using ultrasound and confirmed using computed tomography
(CT) and endoscopic retrograde cholangiopancreatography (ERCP). Instead of
the usual surgical treatment, endoscopic balloon dilatation of the sphincter
of Oddi and the distal common bile duct was carried out using an endoscopic
procedure. The patient experienced relief of symptoms, gained weight and felt
healthy again. An ERCP performed in 1990, because of increasing levelsCARETof
liver enzymes and clinical features of abdominal pain and fatigue, revealed
typical cholangiographic findings associated with primary sclerosing cholangitis,
including bile duct irregularities with diffuse narrowing and twisting of
the bile ducts with localized ectatic and strictured areas. Percutaneous needle
liver biopsy confirmed the diagnosis. We conclude that primary sclerosing
cholangitis should be considered when interpreting ERCP films from patients
who are supposed to have choledochal cysts type I.
