Vol.13, No 2, 2006 pp. 90 - 93
UC 616.361:618.2
COMPLICATED CHOLEDOCHAL CYSTS IN PREGNANCY
Dragojlo Gmijović1, Miroslav Stojanović1,
Milan Radojković1, Ljiljana Jeremić1,
Zlatko Širić2
1Surgical Clinic, Clinical Center, Niš, Serbia
2Radiology Institute, Clinical Center, Niš, Serbia
Summary. Choledochal cyst is congenital dilatation of the biliary
tract, present primarily in infants. This condition in pregnancy is very
rare, and the clinical manifestations are nonspecific and variable. In
late pregnancy, the symptoms may exacerbate due to hormonal effects and
the compression of the common bile duct by the enlarging uterus. The need
for urgent therapy of the complications associated with danger of exposing
the mother and fetus to surgical operation and ionizing radiation, always
represent a therapeutic challenge to surgeons. Step-by-step treatment of
complicated choledochal cyst in pregnancy must be carefully planned, once
the diagnosis is established, in order to avoid complication during pregnancy.
Definitive surgical management of the choledochal cyst should be delayed
until the patient's general physiological condition becomes normal after
elective cesarean section. We reported our experience in managing a case
of choledochal cyst in pregnant patients, complicated with cholangitis
and review the literature regarding choledochal cyst in pregnancy.
Key words: Choledochal cyst,
pregnancy, cholangitis
KOMPLIKOVANA CISTA DUCTUS CHOLEDOCHUS-A
U TRUDNOĆI
Kratak sadržaj: Holedohalna cista predstavlja kongenitalnu dilataciju
bilijarnog stabla koja se uglavnom javlja kod novorođenčadi. Ovo stanje
u trudnoći je veoma retko sa nespecifičnim i promenljivim kliničkim manifestacijama.
U kasnijoj trudnoći može doći do egzacerbacije tegoba usled hormonskih
efekata i kompresije glavnog žučnog voda uvećanim uterusom. Potreba za
urgentnom hirurškom terapijom komplikacija povezana sa opasnošću od izlaganja
majke i fetusa hirurškoj intervenciji i jonizujućem zračenju, uvek predstavlja
terapijski izazov za hirurga. "Step by step" lečenju komplikovane holedohalne
ciste u trudnoći mora biti pažljivo isplanirano čim se pojavi dijagnoza,
da bi se izbegle komplikacije tokom trudnoća. Definitivno hirurško lečenje
holedohalne ciste treba odložiti dok opšte fiziološko stanje pacijenta
ne postane normalno nakon elektivnog carskog reza. Saoštili smo naše iskustvo
u tretmanu slučaja holedohalne ciste kod trudnica, komplikovanih olangitisom
i dali pregled literature u vezi holedohalne ciste u trudnoći.
Ključne reči: holedohalna
cista, trudnoća, holangitis
