American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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Type 4 choledochal cysts are defined by which condition?

Intrahepatic only
Low CBD cyst
Both intra and extrahepatic
Outpouching

The correct answer is: Both intra and extrahepatic

Type 4 choledochal cysts are characterized by both intrahepatic and extrahepatic dilation of the bile ducts. This specific classification indicates that there are cystic dilations not only in the extrahepatic bile ducts but also within the intrahepatic bile ducts, which differentiates it from other types of choledochal cysts. Type 4 is particularly significant because it represents a complex anatomical disorder that requires careful consideration in management due to the involvement of both intrahepatic structures and potential complications such as biliary obstruction and risk of cholangiocarcinoma. Understanding this characteristic is crucial for medical professionals managing patients with bile duct anomalies.