Digestive and Gastrointestinal Conditions

Choledochal Cyst Symptoms and Diagnosis

Symptoms of Choledochal Cyst

Some newborns with cysts have symptoms right away. Others have good bile flow at first, but they get symptoms soon after birth. Some children don't have symptoms for a couple of years or longer. Some people live with a choledochal cyst for many years but don't know about it because they don't have symptoms until they are an adult.

Babies or children with a choledochal cyst may have these symptoms:

  • Yellow color to the eyes and skin (jaundice)
  • Pain in the upper right belly (upper right quadrant pain)
  • Soft mass that can be felt in the upper right belly
  • Pale or clay-colored stools (feces)
  • Fever, if they have an infection (cholangitis)
  • If they have an inflamed pancreas (pancreatitis): belly pain that may come and go, nausea and vomiting

Choledochal Cyst Diagnosis

Sometimes doctors can see a choledochal cyst on an ultrasound before a baby is born (prenatal ultrasound). If this happens with your baby, doctors will plan the tests and treatment your baby will need after birth. It's not always possible to see a cyst before birth.

If your child's cyst was not seen but your child has symptoms after they are born, your child's doctor will ask for a detailed history of your child's illness. The doctor will do a thorough exam.

There is no blood test for choledochal cysts. But the doctor may do blood tests to check whether your child's bile ducts are inflamed or infected and whether their liver is working well.

The doctor will do an ultrasound of your child's belly (abdomen) to see your child's bile ducts and other organs in the area. Imaging studies like ultrasound help the doctor know whether there is a cyst, where it is and how it is shaped. These factors help your child's doctor plan surgery to remove the cyst.

Your child may also need other imaging studies, like these:

  • Cholangiography - injecting dye (contrast) into your child's bile ducts and then taking an X-ray. This may be done in one of two ways. One way is to inject the dye through your child's skin and liver into their ducts (percutaneous transhepatic cholangiography, PTC). The other way is to inject the dye through a small tube placed into your child's mouth and down their throat into their intestine (endoscopic retrograde cholangiopancreatography, ERCP).
  • Abdominal CT (computed tomography) scan.
  • Abdominal MRI (magnetic resonance imaging) scan.
  • HIDA scan (hepatobiliary iminodiacetic acid scan). A HIDA scan allows doctors to see whether a special dye that collects in the liver can pass out of the liver through the bile ducts.