Q44.4 Choledochal cyst

ICD10CM code

#### Name of the Condition
- Choledochal cyst
- Also known as bile duct cyst

#### Summary
Choledochal cysts are congenital anomalies where cystic dilations occur in the bile ducts, which can lead to biliary obstruction, recurrent inflammation, and other complications if not treated.

#### Causes
The exact cause is not well-understood, but it is believed to be related to abnormal fetal development of the bile ducts. A commonly suspected mechanism involves an abnormal connection between the bile and pancreatic ducts.

#### Risk Factors
- Genetic predisposition may play a role.
- Predominantly observed in females and in some populations in Asia.

#### Symptoms
- Jaundice (yellowing of the skin and eyes)
- Abdominal pain
- Nausea and vomiting
- Fever (if infection is present)
- Palpable abdominal mass

#### Diagnosis
- Ultrasound is commonly used for initial assessment.
- CT scan or MRI can provide detailed images of the bile ducts.
- Magnetic Resonance Cholangiopancreatography (MRCP) is used for a non-invasive bile duct visualization.
- Endoscopic Retrograde Cholangiopancreatography (ERCP) may be used for detailed imaging as well as therapeutic purposes.

#### Treatment Options
- Surgical removal of the cyst is the primary treatment to prevent complications.
- Hepaticojejunostomy may be performed to ensure bile drainage.
- Antibiotics may be necessary if an infection is present.

#### Prognosis and Follow-Up
- With timely surgical intervention, the prognosis is generally good.
- Regular follow-up is crucial to monitor for liver function and any signs of complications.

#### Complications
- Risk of cholangitis (bile duct infection)
- Potential development of bile duct cancer
- Liver cirrhosis if left untreated

#### Lifestyle & Prevention
- As choledochal cysts are congenital, prevention is not currently possible.
- Maintaining good liver health and regular medical check-ups can help manage symptoms and monitor for complications.

#### When to Seek Professional Help
- Sudden onset of severe abdominal pain
- Persistent jaundice
- Recurrent fever or signs of infection

#### Additional Resources
- American Liver Foundation: [Liver Foundations](https://liverfoundation.org)
- National Institute of Diabetes and Digestive and Kidney Diseases: [NIDDK](https://www.niddk.nih.gov)
- Local patient support groups for those with congenital liver issues

#### Tips for Medical Coders
- Ensure the ICD code **Q44.4** is used specifically for choledochal cyst cases.
- Verify accompanying symptoms and complications for possible additional codes.
- Avoid misclassification with other bile duct obstructions by using detailed clinical documentation.

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