A choledochal cyst is a rare condition in children where the bile ducts, which carry bile from the liver to the small intestine, are abnormally enlarged. While some cysts are found on prenatal ultrasound, symptoms in children typically include a combination of abdominal pain, a mass in the abdomen, and jaundice (yellowing of the skin and eyes).
Because of the risk of serious complications, including liver damage, pancreatitis, and an increased risk of developing bile duct cancer later in life, surgical removal of the cyst is recommended. The procedure involves removing the entire enlarged portion of the bile duct and connecting the remaining bile duct directly to the small intestine. This can be done with an open or laparoscopic surgery.
Biliary atresia is a serious liver disease in infants where the bile ducts, which drain bile from the liver, are blocked or absent. This causes bile to back up, leading to liver damage. The condition usually presents in the first few weeks of life. Parents often notice jaundice (yellowing of the skin and eyes) that doesn’t go away, and their baby may have dark urine and pale, clay-coloured stools.
Management begins with a surgical procedure called the Kasai hepatoportoenterostomy. In this surgery, the surgeon removes the damaged bile ducts and connects a loop of the small intestine directly to the liver. This allows bile to drain and can prevent or delay the need for a liver transplant.
Gallstones in children, though less common than in adults, are increasingly diagnosed. The most common symptom is right-sided abdominal pain, often triggered by fatty meals and may be accompanied by nausea and vomiting. The stones may not cause any symptoms at all.
Management involves surgical removal of the gallbladder (cholecystectomy), performed laparoscopically (keyhole surgery) to avoid complications like infection or slippage of stone into the bile duct.
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