choledochal cyst

[olsonkl]

I am a 33 year old 110lb. female that just gave birth to her second child 4 months ago.  I had my first gallbladder attack about 3 weeks ago, and I ended up in the ER.  Since then I have had a zero tolerance for fats (butter, oils, mayo, salad dressing etc....), but if I ate correctly I had no problem.  My main symptoms were GI related, gurgling of stomach, diahrea, severe indigestion, headaches, nausea and vomitting.I had my gallbladder removed about 5 days ago, and it was found to have chronic cholesititis (inflammation) and sluggish bile.  One other finding was that I have a 1 inch choledochal cyst on my bile duct.  Since the surgery I have had identical problems as those seen prior to my surgery.  My husband and I are wondering how likely it is that this cyst is also causing some of these problems.  My problems again are GI related, gurgling of stomach, diahrea, severe indigestion, headaches, nausea and vomitting.  What are these cysts?  How concerned should I be?  How likely is it that this cyst is causing my problems again???I recognize that it is soon after surgery, but I am having identical problems and see no relief insight.  Any advice?

[Kevin Pho, MD]

Hello - thanks for asking your question.

Biliary cysts are cystic dilatations, which may occur singly or in multiples throughout the bile ducts.  The cysts can cause chronic and intermittent abdominal pain - however since you also had a cholecystectomy 5 days ago, it is also possible that your symptoms may be from surgery as well.

Biliary cysts are associated with an increased risk of cancer, particularly cholangiocarcinoma.  Choledochal cysts also have an association with complications such as the aforementioned cancer, pancreatitis, and cholangitis.  If you continue to have symptoms, then surgical or endoscopic repair of the cyst should be considered.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

five days after surgery is really too soon to know what's what: the symptoms you are having could just be various post op issues, from inflamation (inflammation) persisting in the area, to medication related, to meaning the gallbladder was not the problem in the first place. I'm sure any surgeon or gastroenterologist would opt to give it more time  before looking into it further: there's a good chance what you are experiencing will go away. Choledochal cysts are not common but aren't highly rare, either. You are born with them. Most aren't a problem and don't give symptoms. It depends on where exactly they are in the bile duct. I'd say it's not likely it has anything to do with anything, but not knowing the anatomy it's not really possible to say. It's something to consider if your symptoms persist

[surgeon]

I should add this: choledochal cyst CAN be a big deal, generally in the newborn. In other words, when they are significant, they are pretty large and cause bile blockage shortly after birth. So when it's found in an adult, it generally means it's so small or located such that it's not of physiological significance. And when they are of significance, usually there is jaundice (yellowing of the skin and eyes), fever from infection in the bile, and those would be pretty obvious things....

[olsonkl]

Thank you so much for your responses, it is really helpful to get a second opinion.  I have a follow-up scheduled for next week with a specialist.  Does anyone know how long it is considered "normal" post gallbladder removal to have these symptoms (diahrea, gurgling, nausea) after eating fatty substances.  My fear is this will not be temporary.

[martima1]

Hi,
I had the same symptoms when I got my GB removed. My Dr said it would take some time for my body to get used to the fact that I didnt have a Gb anymore. Now that your Gb is gone, the bile from th eliver just goes straight to your intestines, causing the diarhea (diarrhea). i would stay away from fatty foods, because your liver will make more bile to help your stomach break down the fats, and thsi will aggravate your symptoms. While I'm not exactly back to normal (see my post) I can say that if I lay off the fats and cholesterol, i dont have the sympptoms as much..
Take care and good luck -
Martima1

[ilovelife]

Hello- this may  be too late but just wanted to add....I am a 34 yr old woman who had a rather large choledochal cyst(which was causing me problems). I found this out after my PCP sent me for a sonogram, then CAT scan then an MRCP. My advice, do not take this lightly until you are 100% sure its not a problem.  Since mine was causing me problems(back pain, stomach pain, and chills), I was scheduled for surgery on 5/28.  When I wasn't too medicated a few days later....I was informed my surgery was 7 1/2 hours (called the whipple procedure) and I have cancer.  The cancer originated in the cyst/bile duct. Needless to say I'll be starting chemo. soon.   Not that you will have this problem, I just thought after reading the other responses you should know the cyst can lead to bad things so I would suggest at least more tests to be sure. God bless.

[suzy401]

A related discussion, cyst in biliary ducts was started.