A 25-year-old woman with recurrent cholangitis undergoes MRCP, which shows fusiform dilatation of both the extrahepatic bile duct and the right and left intrahepatic ducts. The gallbladder and pancreatic duct appear normal. According to the Todani classification, this is which type of choledochal cyst?
- A Type Ia
- B Type IVa ✓
- C Type III
- D Type II
Correct answer: B. Type IVa
Explanation
Todani type IVa denotes multiple cystic dilatations involving both intrahepatic and extrahepatic bile ducts, exactly as described. Type I is extrahepatic only (fusiform, saccular, or choledochal), type II is a true diverticulum of the common bile duct, and type III is a choledochocele confined to the intraduodenal portion. Type IVb involves multiple segments of the extrahepatic duct alone. Treatment requires complete excision with hepaticojejunostomy because of malignancy risk.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.