Gastroenterology and hepatology: choledochal cyst: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology and hepatology: choledochal cyst

Sample item

A 4-year-old girl has intermittent jaundice, abdominal pain and a right upper quadrant mass. Ultrasonography shows fusiform dilatation of the common bile duct. What is the treatment of choice?

ACyst-enterostomy internal drainageBEndoscopic stenting every 6 monthsCComplete cyst excision with hepaticojejunostomyDRepeated percutaneous drainage

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Complete cyst excision with hepaticojejunostomy

Choledochal cysts predispose to cholangitis, stones, pancreatitis and cholangiocarcinoma. Complete excision of the cyst with Roux-en-Y hepaticojejunostomy removes the malignant potential. Internal drainage leaves the cyst wall in place and carries a continuing cancer risk.

Option by option

A. Cyst-enterostomy internal drainage
Drainage into bowel leaves the cyst wall and its malignant risk.
B. Endoscopic stenting every 6 months
Repeated stenting is not definitive and carries a risk of cholangitis.
C. Complete cyst excision with hepaticojejunostomy (correct)
Correct. Excision removes the premalignant cyst wall and restores bile drainage.
D. Repeated percutaneous drainage
Percutaneous drainage is temporary and does not cure the condition.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Complete cyst excision with hepaticojejunostomy. Choledochal cysts predispose to cholangitis, stones, pancreatitis and cholangiocarcinoma.

Why is "Cyst-enterostomy internal drainage" not the answer?

Drainage into bowel leaves the cyst wall and its malignant risk.

Why is "Endoscopic stenting every 6 months" not the answer?

Repeated stenting is not definitive and carries a risk of cholangitis.

Why is "Repeated percutaneous drainage" not the answer?

Percutaneous drainage is temporary and does not cure the condition.

What concept does this question test?

It tests Gastroenterology and hepatology: choledochal cyst in General Medicine. Complete excision of the cyst with Roux-en-Y hepaticojejunostomy removes the malignant potential. Internal drainage leaves the cyst wall in place and carries a continuing cancer risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology and hepatology: choledochal cyst?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.