PMC6180854_01
Ultrasound of the abdomen of case 1 showing (a) an anechoic extrahepatic cystic structure (C) adjacent to the main portal vein (P). (b) This cyst (C) was connected to a small and elongated gallbladder (G).
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fig1
A repeat ultrasound showed a small gallbladder (length 1.7 cm; diameter 0.3 cm) connected to an extrahepatic cystic structure, which measured 1.4 x 0.6 cm (Figure 1).
Percutaneous transhepatic transcholecystic cholangiography findings in case 1. (a) Prompt opacification of the known extrahepatic cyst (arrows), which did not show communication with the bile ducts or the duodenum. (b) After sustained injection of contrast, there was a contained retroperitoneal perforation of the cyst/gallbladder (arrows) and no opacification of the bile ducts or the bowel.
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fig2
To definitively exclude a connection of the cyst, the contrast injection was maintained until there was an extraperitoneal perforation of the cyst (Figure 2) (radiation dose: 2.3 mGy).
PMC6180854_02
Percutaneous transhepatic transcholecystic cholangiography findings in case 1. (a) Prompt opacification of the known extrahepatic cyst (arrows), which did not show communication with the bile ducts or the duodenum. (b) After sustained injection of contrast, there was a contained retroperitoneal perforation of the cyst/gallbladder (arrows) and no opacification of the bile ducts or the bowel.
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fig2
To definitively exclude a connection of the cyst, the contrast injection was maintained until there was an extraperitoneal perforation of the cyst (Figure 2) (radiation dose: 2.3 mGy).
Ultrasound of the abdomen of case 2 showing (a) a large anechoic cyst (C), without colour Doppler signal, adjacent to the main portal vein (P). (b) The cyst (C) was connected to a gallbladder (G) with an abnormal appearance (small and elongated).
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fig3
The gallbladder had an unusual, small, irregular appearance measuring 3.9 cm in length and 0.6 cm in diameter (Figure 3).
Percutaneous transhepatic transcholecystic cholangiography findings in case 2. (a) Opacification of a small gallbladder (arrow) connected to a large cyst (C). (b) Sustained contrast injection distended the cyst (C). No communication with the bile ducts or the bowel was demonstrated. The injection was stopped as soon as a contained retroperitoneal perforation was noted (arrows).
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fig4
A PTTC on day 56 of life showed opacification of a small gallbladder connected to a prominent cystic structure (Figure 4).