A 25-year-old woman with a history of infantile jaundice is found to have a cystic dilatation of the common bile duct on MRCP. She has an anomalous pancreaticobiliary duct junction. What is the most significant long-term complication if this lesion is left untreated?
- A Pancreatic pseudocyst formation
- B Cholangiocarcinoma ✓
- C Hepatocellular carcinoma
- D Splenic vein thrombosis
Correct answer: B. Cholangiocarcinoma
Explanation
This describes a choledochal cyst (Todani classification), which results from anomalous pancreaticobiliary duct junction allowing pancreatic enzyme reflux into the bile duct. The most feared complication is cholangiocarcinoma, with a lifetime risk of 10-30%. Excision is recommended even in asymptomatic patients to reduce malignancy risk. HCC is not associated. Pancomatic pseudocyst and splenic vein thrombosis relate to pancreatitis, not choledochal cysts.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.