Bladder Cyst

Facts about a Gall Bladder Cyst

From time to time, an extremely rare disorder can develop that perplexes the medical profession; one such case involves a gall bladder cyst in a condition called choledochal cyst. 

Oddly enough, the incident rate of choledochal cyst from birth in the United States is 1 in 13,000 births, while in Japan it occurs in 1 in 1,000 births, with the majority of cases involving females.  So exactly what is this disorder?  A choledochal cyst is an abnormality involving the common bile duct, and is generally present from birth.  They become problematic during the first year of life in most cases.  It is rare that the disorder presents itself during adulthood; when it does occur, it is associated with complications. 

The common bile duct is an avenue from which bile is transferred from the liver where it is manufactured to the gall bladder, where it is stored until needed.  Bile is used by the body to dissolve fats, eliminate bilirubin and to get rid of cholesterol.  When food is eaten and the process of digestion begins, bile is sent from the gall bladder into the duodenum to assist in the process.  In infants and young children who are afflicted with gall bladder cyst or choledochal cyst, the bile collects in the common bile duct due to the abnormality. A sack, more often referred to as a cyst, forms.  As more and more bile collects, the cyst grows proportionately.  Over time, the cyst presses on the duct and prevents the passage of the bile to the upper chamber of the intestine.  With no outlet, the bile accumulates in the liver.  Jaundice, or yellowing of the skin and eyes, occurs when the bilirubin that is normally secreted from the body by bile builds up in the body. 

The presence of jaundice in infants and toddlers immediately alerts the medical professional that there is a problem in the gall bladder and the liver.  Tests are normally performed to determine the cause of the buildup of bilirubin.  It could be the result of the breakdown of red blood cells in the system, a disease afflicting the liver, or when the biliary system experiences an obstruction, such as the choledochal cyst. 

Several types of choledochal cysts could occur in infants and small children.  Some involve actual cysts that develop in the bile ducts, others with the development of diverticulum of the common bile duct or a simple dilation of the common bile duct that interferes with either the duodenum or other biliary ducts.  In a very small percentage of cases, cancer of the biliary tract could result within the cyst itself, inside the gall bladder or in the bile ducts.  Generally speaking, the younger that the patient is when the carcinoma is discovered, the lower the risk of surgery when cancer is present.  

Treatment of the gall bladder cyst called choledochal involves the complete removal of the anomaly.  When this surgery is required, the biliary system in part or in full will also need to be reconstructed.  Prognosis is generally positive for the small patients, with full recovery anticipated.  In the rare occurrences involving adults, the surgery is also typically successful.  For either age group, removing the cyst with hepaticojejunostomy, a connection the small bowel and the liver is recommended due to the high risk of cancer.

Although the condition is rare, especially in the United States, it does occur on an occasional basis.  While jaundice is a major alert for the condition, it is not a foregone conclusion that gall bladder cyst is the reason.  Immediate professional guidance is required in order to accurately diagnose and treat the condition.