A SURPRISE INTRUDER IN THE WALL OF THE CHOLEDOCHAL CYST - A NOSTALGIC BOND, A CASE REPORT AND REVIEW OF LITERATURE.

Choledochal cyst is a rare congenital malformation of the biliary tract which can be associated with calculi within the cyst – cystolithiasis and gallstones. It is unusual to find heterotopic pancreatic tissue within the wall of choledochal cyst. We hereby report a case of a 43 year old female, who presented with complaints of recurrent abdominal pain with fever for the past 2 months. Magnetic resonance cholangiopancreatogram (Plain) showed features of acute/subacute cholecystitis. Focal cystic dilatation of proximal common bile duct with choledocholithiasis, type Ib choledochal cyst, Hepatolithiasis with mild intrahepatic biliary radicals dilatation were noted. The patient was planned for cholecystectomy with excision of choledochal cyst. Microscopic examination of the cystwall showed a fibrocollagenous cyst wall lined by single layer of columnar epithelium. The cystwall showed lobules of pancreatic acini consistent with heterotopic pancreatic tissue. Gall bladder showed features of chronic cholecystitis. We report this case of heterotopic pancreatic tissue in choledochal cyst with cystolithiasis and cholelithiasis occurring simultaneously and due to its rarity