Abstract
<jats:p>Choledochal cysts are rare congenital anomalies of the biliary system, with Todani type IVa involving both intrahepatic and extrahepatic bile ducts. Accurate classification and identification of associated biliary anatomical variants are essential for appropriate management and surgical planning. We report the case of a 20-year-old female who presented with postprandial abdominal pain and was referred for Magnetic Resonance Cholangiopancreatography (MRCP) following a suspicious ultrasound examination. MRCP demonstrated fusiform dilatation of the extrahepatic bile duct with multifocal dilatation of the intrahepatic biliary radicles, consistent with a Todani type IVa choledochal cyst. An associated hepatic duct anatomical variant (type II) was also identified. Laboratory parameters were within normal limits, and no surgical intervention had been undertaken at the time of presentation. This case highlights the pivotal role of MRCP in the non-invasive diagnosis, classification, and comprehensive biliary mapping of choledochal cysts. The co-existence of a choledochal cyst with a hepatic duct anatomical variant makes this case unique and has significant implications for surgical planning.</jats:p>