Bile duct obstruction – Choledochal Cysts and Gallstones

Some children develop blockage to bile flow from causes other than biliary atresia.

This often happens in older children but can happen in infants as well. Two more common causes of bile obstruction include gallstones and choledochal cysts.

Gallstones refer to the formation of hard stone-like structures in the gallbladder. These are for more common in adults than in children. Some children may have other conditions that cause them to form gallstones, these are commonly conditions that affect the red blood cells and cause them to break down sooner than usual. This breakdown of red blood cells may result in the formation of gallstones.

Not all gallstones cause problems or symptoms. There are probably many people walking around with gallstones who are unaware of it. They can however result in pain, blockage of the bile ducts and jaundice, as well as inflammation and infection of both the gallbladder and pancreas.

If symptoms of gallstones occur or if your child is predisposed to forming gallstones, then they may require an operation. This generally involves removing the gallbladder as well as any stones that are still blocking the bile ducts. This operation is carried out with laparoscopic (key-hole) surgery but may also require open surgery and/or endoscopy.

A Choledochal cyst refers to a condition where the bile ducts become dilated and swollen resulting in a blockage to bile flow from the liver to intestines. Although it is thought to be a condition that children are born with, they may only develop symptoms later in life. It is also a rare cause of jaundice in adults. These children also present with jaundice and the diagnosis is usually made with a combination of blood tests, ultrasounds and specialized scans.

An operation is required to remove the dilated/swollen part of the bile ducts and allow the bile to drain into the intestines.

Even after successful surgery your child will need to be followed up for life as they have an increased risk for developing cancer of the bile ducts at a later stage.