**Question:** Clinical features of choledochal cyst in adult are -

A. Jaundice
B. Hepatomegaly
C. Abdominal pain
D. Gastrointestinal bleeding

**Core Concept:** Choledochal cyst is a congenital cystic dilatation of the extrahepatic bile ducts, most commonly the cystic duct and common bile duct. It occurs due to a failure of the cystic duct to fuse with the common bile duct during development.

**Why the Correct Answer is Right:** The correct answers (A, C) are related to the clinical features of choledochal cyst in adults. Jaundice and abdominal pain are common symptoms in adults with choledochal cyst, as the dilated bile ducts can lead to liver dysfunction, obstructive jaundice, and resultant abdominal pain.

**Why Each Wrong Option is Incorrect:**

Option B (Hepatomegaly) is incorrect because hepatomegaly is expected in cholestatic liver diseases, which are caused by obstruction of the bile ducts. Since choledochal cyst is a cause of obstructive jaundice, hepatomegaly is not a common feature in adults with choledochal cyst.

Option D (Gastrointestinal bleeding) is incorrect as gastrointestinal bleeding is a feature of conditions like portal hypertension, liver cirrhosis, or malignancy, not choledochal cyst itself. The cyst does not directly lead to gastrointestinal bleeding.

**Clinical Pearl:**

Choledochal cyst in adults can be diagnosed using imaging studies like ultrasound, CT scan, or MRI cholangiography. Surgery is the treatment of choice for choledochal cyst, usually involving excision of the cyst and reconstruction of the biliary tree. Early diagnosis and management can prevent complications such as cholangitis, cholangiocarcinoma, and liver cirrhosis.

**Correct Answer:** D. Jaundice

**Explanation:**

In adults, choledochal cyst presents with symptoms like jaundice due to the dilatation of the bile ducts causing obstruction, leading to impaired bile flow and increased bile pigments in the bloodstream, causing jaundice.