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Li Y, Li C, Wu H, Wang Q, Gao ZD, Yang XD, Jiang KW, Ye YJ. Clinical features of gastric duplications: evidence from primary case reports and published data. Orphanet J Rare Dis 2021; 16:368. [PMID: 34412674 PMCID: PMC8377950 DOI: 10.1186/s13023-021-01992-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/01/2021] [Indexed: 01/07/2023] Open
Abstract
Background Alimentary tract duplications are rare congenital lesions, and only 2–8% of them are located in the stomach. Gastric duplications (GD) can lead to severe adverse events. Thus, surgical resection is required once the disease is diagnosed. The main purpose of this study is to describe the clinical features of gastric duplications and to provide evidence for the diagnosis and treatment. Methods A retrospective review of eight gastric duplications at two medical centers Peking University People’s Hospital (PKUPH) and Shandong Provincial Hospital from 2010 to 2020 was conducted. Furthermore, the literature search was also conducted by retrieving data from PubMed, EMBASE and Cochrane Library databases from the date of the database inception to January 15, 2021. Results Eight patients who were diagnosed as gastric duplications and 311 published records were included in this study. In all, 319 patients were identified: Vomiting and abdominal pain were the most frequent clinical presentations among juveniles and adults respectively. There was no difference in gender distribution (F: 53.16% vs M: 46.84%), and the cystic gastric duplications were the most common type of the gastric duplications (87.04%). More than half (53.30%) of included cases were located in the greater curvature of stomach. Conclusions Gastric duplications could present with a wide spectrum of symptomatology, which might be misdiagnosed easily as other diseases. For cystic gastric duplications, the optimal treatment was a complete surgical removal. But conservative treatment might be an alternative strategy for tubular gastric duplications.
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Affiliation(s)
- Yang Li
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Chen Li
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Hao Wu
- Department of Gastroenterological Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Quan Wang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Zhi-Dong Gao
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xiao-Dong Yang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Ke-Wei Jiang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
| | - Ying-Jiang Ye
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
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2
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Doya LJ, Hassan NT, Bijow FW, Mansour HA, Ahmad S, Nooh F, Ibrahim A. An unusual cause of recurrent pediatric vomiting (an extraluminal pyloric duplication cystic): A case report. Oxf Med Case Reports 2021; 2020:omaa119. [PMID: 33391775 PMCID: PMC7768520 DOI: 10.1093/omcr/omaa119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/08/2020] [Accepted: 10/22/2020] [Indexed: 12/22/2022] Open
Abstract
Vomiting is a common symptom of a multitude of diseases in children. It is usually part of benign illness and can occur at any age. Recurrent vomiting can be a symptom of life-threatening medical or surgical emergencies. It can be rarely caused by an extraluminal pyloric duplication cyst. Early recognition is essential for preventing delays in management and potential complications. Here we report a case of an extraluminal pyloric duplication presenting as progressive gastric outlet obstruction cyst in a 14-month-old Syrian boy. The diagnosis was made through abdominal ultrasound, gastrointestinal endoscopy and abdominal computed tomography scan.
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Affiliation(s)
- Leen Jamel Doya
- Department of Pediatrics, Tishreen University Hospital, Latakia, Syria
| | | | | | | | - Sawsan Ahmad
- Department of Pediatrics, Tishreen University Hospital, Latakia, Syria
| | - Fedaa Nooh
- Department of Pediatrics, Tishreen University Hospital, Latakia, Syria
| | - Ali Ibrahim
- Department of Pediatrics, Professor of Gastroenterology and Hepatology, Tishreen University Hospital, Latakia, Syria
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3
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McGoran JJ, Mullineux JH, Sutton CD, Kadri SR. Unusual cystic lesion adjacent to the stomach. Gut 2020; 69:1161-1293. [PMID: 31358577 DOI: 10.1136/gutjnl-2019-318823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 07/02/2019] [Accepted: 07/18/2019] [Indexed: 12/08/2022]
Affiliation(s)
- John J McGoran
- Department of Digestive Diseases, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Joseph H Mullineux
- Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Christopher D Sutton
- Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Sudarshan R Kadri
- Department of Digestive Diseases, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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4
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Shabtaie SA, Infante JC, Danton G, Neville HL, Perez EA, Sola JE, Hogan AR. Accessory pancreatic lobe in association with a gastric duplication cyst. J Pediatr Surg 2017; 53:S0022-3468(17)30574-2. [PMID: 28966008 DOI: 10.1016/j.jpedsurg.2017.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/25/2017] [Accepted: 09/11/2017] [Indexed: 12/11/2022]
Abstract
Gastric duplication cysts are an extremely rare anomaly with few reported cases in association with accessory pancreatic tissue. Diagnosis can be challenging given a presentation of recurrent pancreatitis and resemblance to pancreatic pseudocysts. We report the case of a 6-year old boy with multiple episodes of pancreatitis who was discovered to have an accessory pancreatic lobe connected to a gastric duplication cyst, successfully treated with surgical excision.
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Affiliation(s)
- Samuel A Shabtaie
- Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Juan C Infante
- Division of Pediatric Radiology, Department of Radiology, University of Miami Miller School of Medicine, Miami, FL
| | - Gary Danton
- Division of Pediatric Radiology, Department of Radiology, University of Miami Miller School of Medicine, Miami, FL
| | - Holly L Neville
- Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Eduardo A Perez
- Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Juan E Sola
- Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Anthony R Hogan
- Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.
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5
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Namdaroglu OB, Argon A, Aydogan S, Ozturk AM, Yakan S, Yildirim M, Erkan N. Gastric duplication cyst in adult: Challenge for surgeons. J Minim Access Surg 2017; 13:57-59. [PMID: 27251837 PMCID: PMC5206841 DOI: 10.4103/0972-9941.181772] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 03/05/2016] [Indexed: 12/28/2022] Open
Abstract
Gastric duplication cysts (GDCs) are uncommon developmental anomalies found primarily in children, being rarely seen in adults. Duplications can occur anywhere in the intestinal tract from the mouth to the anus. Accurate diagnosis of cysts before resection is difficult even using the most advanced imaging techniques. In this report, we present and discuss a case of GDC in a 25-year-old man treated laparoscopically. Patient admitted to our department with complaints of epigastric pain and swelling. Magnetic resonance imaging performed for accurate characterisation showed a 4 cm × 4.5 cm cystic lesion, with heterogeneous signal intensity on T2-weighted images, located in the posterior wall of the stomach. Pre-operative differential diagnosis including gastrointestinal stromal tumour (GIST) was made according to radiological findings. Patient underwent surgery and cyst resected laparoscopically. Histopathological examination suggesting duplication cyst. GDC can easily be mistaken for a GIST, and the clinician as well as radiologist must maintain a high degree of suspicion.
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Affiliation(s)
- Ozan Barıs Namdaroglu
- Department of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Asuman Argon
- Department of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Serdar Aydogan
- Department of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ahmet Mucteba Ozturk
- Department of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Savas Yakan
- Department of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Mehmet Yildirim
- Department of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Nazif Erkan
- Department of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
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6
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Yamasaki A, Onishi H, Yamamoto H, Ienaga J, Nakafusa Y, Terasaka R, Nakamura M. Asymptomatic adenocarcinoma arising from a gastric duplication cyst: A case report. Int J Surg Case Rep 2016; 25:16-20. [PMID: 27289170 PMCID: PMC4908310 DOI: 10.1016/j.ijscr.2016.05.055] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 05/17/2016] [Accepted: 05/31/2016] [Indexed: 12/19/2022] Open
Abstract
Adenocarcinoma arising from a gastric duplication cyst is extremely rare. This is the 2nd asymptomatic case in the English literature. During our close observation of 4 years, malignant transformation had occurred from a gastric duplication cyst. When morphological change appears, we strongly recommend surgical treatment without delay. Introduction Duplication of the alimentary tract is a relatively uncommon congenital anomaly and most cases occur in childhood. Malignancy arising from a gastric duplication cyst is extremely rare. We herein report a very rare case of malignant transformation of a gastric duplication cyst. Presentation of case A 47-year-old asymptomatic Japanese woman was referred to our hospital with a large abdominal mass adhered to the stomach. Since there was a possibility of malignant transformation, complete resection of the cyst and segmental gastrectomy without regional lymphadenectomy were performed. Discussion To our knowledge, this is the 2nd report of asymptomatic adenocarcinoma arising from a gastric duplication cyst in the English-language literature. Unfortunately, the patient developed peritoneal metastasis and ascites seven months after the surgery and died. Conclusion From our long-term follow-up experience of this gastric duplication cyst, we recommend making accurate diagnosis as soon as possible with biopsy using endoscopic ultrasonography. When the disease is diagnosed as malignant, we recommend gastrectomy with lymphadenectomy. Even if the disease is diagnosed as benign, we recommend close observation with imaging modalities.
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Affiliation(s)
- Akio Yamasaki
- Department of Cancer Therapy and Research, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; Department of Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka 815-8555, Japan.
| | - Hideya Onishi
- Department of Cancer Therapy and Research, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Hirofumi Yamamoto
- Department of Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka 815-8555, Japan
| | - Jun Ienaga
- Department of Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka 815-8555, Japan
| | - Yuji Nakafusa
- Department of Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka 815-8555, Japan
| | - Reiji Terasaka
- Department of Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka 815-8555, Japan
| | - Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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7
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Udiya AK, Shetty GS, Chauhan U, Singhal S, Prabhu SM. Multiple Isolated Enteric Duplication Cysts in an Infant - A Diagnostic Dilemma. J Clin Diagn Res 2016; 10:TD15-6. [PMID: 26894149 DOI: 10.7860/jcdr/2016/15129.7129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 10/11/2015] [Indexed: 12/24/2022]
Abstract
Completely isolated enteric duplication cysts are a rare variety of enteric duplication cysts having an independent blood supply with no communication with any part of the adjacent bowel segment. We report a case showing two completely isolated enteric duplication cysts originating in the greater omentum and transverse mesocolon in an infant. Multiple isolated enteric duplication cysts involving non-contiguous bowel segments have not been previously reported in the literature. In addition the transverse mesocolon duplication cyst was infected showing septations and loss of double wall sign resulting in difficulty in imaging diagnosis. Both the cysts were excised and confirmed on histopathology.
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Affiliation(s)
- Alok Kumar Udiya
- Senior Resident, Department of Radiodiagnosis, Institute of Liver and Bilary Sciences , New Delhi, India
| | - Gurucharan S Shetty
- Senior Resident, Department of Radiodiagnosis, All India Institute of Medical Sciences , New Delhi, India
| | - Udit Chauhan
- Senior Resident, Department of Radiodiagnosis, GB Pant Hospital , New Delhi, India
| | - Shweta Singhal
- Senior Resident, Department of Radiodiagnosis, Lady Hardinge Medical College and assoc. SSK and KSC hospitals , Connaught Place, New Delhi, India
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8
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Liu K, Lin X, Wu J, Liu H, Meng M, Su H, Tai W, Chang H. Peritoneal metastatic adenocarcinoma possibly due to a gastric duplication cyst: a case report and literature review. BMC Gastroenterol 2014; 14:48. [PMID: 24641252 PMCID: PMC3994556 DOI: 10.1186/1471-230x-14-48] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 03/10/2014] [Indexed: 02/08/2023] Open
Abstract
Background Gastric duplication cysts are rare congenital abnormalities, and malignant transformation of these duplications is also thought to be rare. Case presentation During a routine health checkup, a 28-year-old man underwent abdominal sonography followed by computed tomography (CT) with contrast agent, which revealed a cystic lesion with no enhancement. Laparoscopic surgery showed a 10 × 10 cm cyst adhering to the gastric corpus. However, attempts to remove the lesion en bloc were unsuccessful, and the ruptured cyst had contaminated the peritoneal cavity. Gastric duplication was diagnosed from microscopic examination of the cyst. Seven months later, the patient suffered a progressive increase in ascites, and repeated cytological analysis showed small nests of adenocarcinoma cells, with primary lesion unknown. Diagnostic laparoscopy showed multiple white nodules scattered over the surface of the liver, greater omentum, and peritoneum. Biopsy of the omental nodules confirmed adenocarcinoma, while carcinomatosis was diagnosed in the peritoneum. Conclusions Clinical presentation and chronological developments indicated that the malignancy probably originated from the gastric duplication cyst. This case highlights the importance of accurate preoperative diagnosis and optimal surgical management for gastric duplication as well as considering the potential existence of malignant transformation during surgical evaluation of adult patients with gastric duplication cysts.
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Affiliation(s)
| | - Xiangchun Lin
- Gastroenterology Department, Beijing Shijitan Hospital, Capital Medical University, No,10 Tieyi road, Haidian, Beijing 100038, People's Republic of China.
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9
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Trainavicius K, Gurskas P, Povilavicius J. Duplication cyst of the pylorus: a case report. J Med Case Rep 2013; 7:175. [PMID: 23829942 PMCID: PMC3707747 DOI: 10.1186/1752-1947-7-175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 05/23/2013] [Indexed: 01/15/2023] Open
Abstract
Introduction Pyloric duplication is an extremely rare gastrointestinal tract malformation in neonates. This is the first case report of pyloric duplication in our country (Lithuania). Case presentation We report the case of a 2-day-old Lithuanian girl who suffered from pyloric duplication mimicking an alternative common bile duct cyst or other intra-abdominal organs cysts. A laparotomy was performed and the cystic formation of the pyloric area was successfully resected. The postoperative course was uneventful. Conclusions There are only a few reports describing abdominal masses caused by pyloric duplication mimicking common bile duct cyst or other intra-abdominal organs cysts. Therefore thorough clinical and instrumental examination is needed to determine the most accurate diagnosis that allows one to choose the right treatment.
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Affiliation(s)
- Kestutis Trainavicius
- Children's Surgery Centre, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Santariskiu Str, 7, LT 08406, Vilnius, Lithuania.
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10
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Christians KK, Pappas S, Pilgrim C, Tsai S, Quebbeman E. Duplicate pancreas meets gastric duplication cyst: A tale of two anomalies. Int J Surg Case Rep 2013; 4:735-9. [PMID: 23827696 PMCID: PMC3710888 DOI: 10.1016/j.ijscr.2013.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/06/2013] [Accepted: 05/12/2013] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Congenital anomalies are a rare cause of pancreatitis in adults. Gastric duplications are the least common duplication of the gastrointestinal tract and are even more uncommon in the setting of a duplicate pancreas. PRESENTATION OF CASE This manuscript contains a case report and review of the literature of an adult who presented with recurrent pancreatitis and was found to have a gastric duplication cyst that communicated with a duplicate pancreas. The study aim is to alert practitioners to the duplicate anomaly and recommend appropriate therapy. DISCUSSION Combined gastric and pancreatic duplications usually occur in young females with nonspecific, recurrent abdominal pain. This combined duplication can result in pancreatitis when the gastric duplication is contiguous with the stomach. Heightened awareness of the condition, appropriate diagnostics with accurate interpretation and a minimalist approach to resection are warranted. CONCLUSION Recurrent abdominal pain and pancreatitis in young adults devoid of risk factors should lead to consideration of congenital anomalies. Not all cysts near the pancreas and stomach are pseudocysts. ECRP and abdominal CT/MRI provide critical diagnostic information. This dual anomaly is best treated by simple excision of the gastric duplication and heterotopic pancreas.
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11
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Lee SY, Ko JS. [Gastric duplication cyst with ectopic pancreas in a child]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2013; 60:391-3. [PMID: 23367543 DOI: 10.4166/kjg.2012.60.6.391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Sang Youp Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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12
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Sari S, Kara K, Verim S, Karahan N. Gastric foregut duplication cyst as a rare cause of abdominal pain. Eurasian J Med 2012; 44:182-4. [PMID: 25610238 DOI: 10.5152/eajm.2012.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 09/13/2012] [Indexed: 11/22/2022] Open
Abstract
Gastric foregut cyst is a rare congenital disease. In this report, a gastric foregut cyst in a 22-year-old male patient is presented. Fluid-filled gastric ultrasonography and computed tomography demonstrated a cystic, calcified lesion attached to the anterior gastric wall. The same lesion was observed using upper gastrointestinal endoscopy. An exploratory laparotomy revealed a non-communicating cyst. The cyst was excised surgically, and pathology confirmed the diagnosis.
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Affiliation(s)
- Sebahattin Sari
- Clinic of Radiology, Isparta Military Hospital, Isparta, Turkey
| | - Kemal Kara
- Clinic of Radiology, Beytepe Miltary Hospital, Ankara, Turkey
| | - Samet Verim
- Clinic of Radiology, Ankara Miltary Hospital, Ankara, Turkey
| | - Nermin Karahan
- Department of Pathology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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13
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Sharma D, Bharany RP, Mapshekhar RV. Duplication cyst of pyloric canal: a rare cause of pediatric gastric outlet obstruction: rare case report. Indian J Surg 2012; 75:322-5. [PMID: 24426605 DOI: 10.1007/s12262-012-0697-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 06/28/2012] [Indexed: 12/11/2022] Open
Abstract
Duplication of the alimentary tract may occur in any site, from the mouth to the anus, and in recent years such anomalies have received wide notice. Pyloric duplication cyst is an extremely rare congenital anomaly of the alimentary tract, whose clinical presentation often mimics those of hypertrophic pyloric stenosis. Gastrointestinal duplications are observed in 1 of every 4500 autopsies, predominantly in white males. It represents 2.2 % of all gastric duplications, with only 18 have been reported up to 2011 (Table 1). In most cases preoperative diagnosis is not made. We report a case of a pyloric duplication cyst in a 3-year-old girl with progressive increased vomiting. The patient had an ultrasonography, upper gastrointestinal series, and computer tomography of the abdomen. The diagnosis was confirmed by surgery and histopathology examination. The patient was asymptomatic at 12-month follow-up. The clinical and radiological analysis can reveal configurational changes consistent with a large extrinsic mass rather than muscular hypertrophy and can lead to accurate preoperative diagnosis.
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Affiliation(s)
- Dhawal Sharma
- Department of General Surgery, S.B.K.S. Medical and Research Institute, Sumandeep Vidhyapeeth, Waghodia, Vadodara, Gujarat, India ; Room no.209, N.R.I. Hostel, Sumandeep Vidhyapeeth, 391760 Pipariya, Waghodia Dist-Vadodra India
| | - R P Bharany
- Department of General Surgery, S.B.K.S. Medical and Research Institute, Sumandeep Vidhyapeeth, Waghodia, Vadodara, Gujarat, India
| | - R V Mapshekhar
- Department of General Surgery, S.B.K.S. Medical and Research Institute, Sumandeep Vidhyapeeth, Waghodia, Vadodara, Gujarat, India
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14
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Zheng J, Jing H. Adenocarcinoma arising from a gastric duplication cyst. Surg Oncol 2012; 21:e97-101. [PMID: 22456198 DOI: 10.1016/j.suronc.2012.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 03/05/2012] [Accepted: 03/07/2012] [Indexed: 01/07/2023]
Abstract
Malignant transformation in a gastric duplication cyst (GDC) is extremely rare, with only eight reported cases to date. An additional case of an adenocarcinoma arising from a GDC in a 25-year-old male is reported here. Ultrasonography and computed tomography (CT) scans detected a well-defined cyst arising from the greater curvature of the stomach. The patient was submitted to en-bloc resection of the mass with total gastrectomy and regional lymphadenectomy. At the time of laparotomy, the unilocular cyst was full of a thick substance and had no association with the gastric lumen. Microscopic examination revealed that the cystic mass had a well-formed cyst wall with an inner mucosal lining, submucosal layer, muscularis propria, and outer serosal layer. The inner cyst was lined by gastric mucosa. A mediated differentiated adenocarcinoma was found in the duplication cyst, which had invaded the serosa of the cyst wall and the gastric muscular wall. To our knowledge, this is the youngest and only asymptomatic patient in whom neoplastic GDC changes have been reported.
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Affiliation(s)
- Jinfeng Zheng
- Department of Pathology, The General Hospital, Jinan Military Command, Shifan Road 25, Jinan, Shandong Province, PR China
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15
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Laparoscopic Excision of Foregut Duplication Cyst of Stomach. APOLLO MEDICINE 2010. [DOI: 10.1016/s0976-0016(11)60097-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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16
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Oeda S, Otsuka T, Akiyama T, Ario K, Masuda M, Taguchi S, Shono T, Kawazoe S. Recurrent acute pancreatitis caused by a gastric duplication cyst communicating with an aberrant pancreatic duct. Intern Med 2010; 49:1371-5. [PMID: 20647650 DOI: 10.2169/internalmedicine.49.3392] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A 38-year-old woman was hospitalized in August 2007. This visit was her fifth episode of acute pancreatitis. Computed tomography revealed a cystic structure located near the antrum. Communication between this structure and the pancreatic duct was revealed by endoscopic retrograde cholangiopancreatography. Ultrasonography revealed that the cyst wall had a layered structure. Thus, we regarded it as a gastric duplication cyst. We thought that the gastric duplication cyst communicating with an aberrant pancreatic duct was responsible for the recurrent acute pancreatitis. In August 2008, a cyst gastrostomy was performed between the gastric duplication cyst and the stomach. No recurrence of acute pancreatitis has since occurred.
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Affiliation(s)
- Satoshi Oeda
- Department of Internal Medicine, Saga Prefectural Hospital, Saga, Japan.
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17
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Affiliation(s)
- Minoru Iwasaki
- Department of Pediatric Surgery, Otsu Red-Cross Hospital, Shiga, Japan.
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18
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Oh JY, Nam KJ, Choi JC, Cho JH, Yoon SK, Choi SS, Kwon HJ, Yoon JH, Kim SJ. Benign submucosal lesions of the stomach and duodenum: Imaging characteristics with endoscopic and pathologic correlation. Eur J Radiol 2008; 67:112-24. [PMID: 17720347 DOI: 10.1016/j.ejrad.2007.06.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2007] [Revised: 06/08/2007] [Accepted: 06/29/2007] [Indexed: 01/07/2023]
Abstract
Benign submucosal lesions of the stomach and duodenum are occasionally encountered during endoscopy. But endoscopy has its limitations in the diagnosis and differentiation of these lesions, because submucosal lesions are often difficult to visualize at endoscopy due to minimal change of the overlying mucosa. Furthermore, endoscopic biopsy may not always yield adequate tissue for diagnosis due to the submucosal location of the lesions. For this reason, the role of radiologic imaging is important in the diagnosis of submucosal lesions of the stomach and duodenum. Recent advances in computed tomography (CT) and sonographic technology are helpful in narrowing the differential diagnosis of gastroduodenal submucosal lesions. In contrast to endoscopy and barium studies, CT or ultrasonography (US) provides information about both the gastric wall and the extragastric extent of the disease. Arterial phase contrast enhanced CT enables us to discriminate a mass of submucosal from that of a mucosal origin in the differential diagnosis of gastric or duodenal lesions. Although endoscopic sonography has been considered the better modality in the diagnosis of gastroduodenal submucosal lesions, transabdominal sonography can still be an alternative method to endoscopic sonography in assessing of the origin and character of the submucosal lesions. Some gastroduodenal submucosal lesions have similar radiologic findings that make differentiation difficult. But despite overlaps in radiologic findings, some lesions have characteristic radiologic features that may suggest a specific diagnosis. Knowledge of the differential diagnosis of benign submucosal lesions in the stomach and duodenum may promote correct diagnosis and appropriate treatment.
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Affiliation(s)
- Jong Young Oh
- Department of Diagnostic Radiology, Dong-A University College of Medicine, Busan, Republic of Korea.
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19
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Bottsford J, Meehan JJ. Common bile duct perforation resulting from a gastric duplication cyst. Pediatr Surg Int 2008; 24:459-61. [PMID: 17646997 DOI: 10.1007/s00383-007-1950-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2007] [Indexed: 11/30/2022]
Abstract
Gastric duplication cysts are a rare cause of abdominal masses in infants. Most children present with a gastric outlet obstruction or some vague abdominal complaints. We present an unusual case of a gastric duplication cyst that created a distal common bile duct obstruction which led to a proximal common bile duct perforation.
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20
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Davies S, Morris-Stiff G, Lewis MH. Gastric duplication cyst mimicking a pancreatic pseudocyst in a patient with chronic pancreatitis. Int J Surg 2007; 6:e70-1. [PMID: 17499033 DOI: 10.1016/j.ijsu.2007.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Revised: 03/08/2007] [Accepted: 03/12/2007] [Indexed: 02/09/2023]
Affiliation(s)
- S Davies
- Department of Surgery, Royal Glamorgan Hospital, Ynysmaerdy, LLantrisant, Rhondda Cynon Taf, CF72 8XR, Wales, UK
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21
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Theodosopoulos T, Marinis A, Karapanos K, Vassilikostas G, Dafnios N, Samanides L, Carvounis E. Foregut duplication cysts of the stomach with respiratory epithelium. World J Gastroenterol 2007; 13:1279-81. [PMID: 17451215 PMCID: PMC4147009 DOI: 10.3748/wjg.v13.i8.1279] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal duplication is a congenital rare disease entity. Gastric duplication cysts seem to appear even more rarely. Herein, two duplications cysts of the stomach in a 46 year-old female patient are presented. Abdominal computed tomography demonstrated a cystic lesion attached to the posterior aspect of the gastric fundus, while upper gastrointestinal endoscopy was negative. An exploratory laparotomy revealed a non-communicating cyst and a smaller similar cyst embedded in the gastrosplenic ligament. Excision of both cysts along with the spleen was performed and pathology reported two smooth muscle coated cysts with a pseudostratified ciliated epithelial lining (respiratory type).
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22
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Chen CP, Liu YP, Hsu CY, Lin SP, Wang W. Prenatal sonography and magnetic resonance imaging of pulmonary sequestration associated with a gastric duplication cyst. Prenat Diagn 2006; 26:489-91. [PMID: 16652397 DOI: 10.1002/pd.1452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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23
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Shah A, More B, Buick R. Pyloric duplication in a neonate: a rare entity. Pediatr Surg Int 2005; 21:220-2. [PMID: 15578189 DOI: 10.1007/s00383-004-1324-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2002] [Accepted: 07/21/2003] [Indexed: 02/03/2023]
Abstract
Duplications of the alimentary tract are rare anomalies that have been reported to occur all along the gastrointestinal tract. Of the various alimentary tract duplications, pyloric duplications are extremely rare. We report the case of a 3-day-old neonate who was antenatally diagnosed as having a cystic mass in the abdomen and who presented with vomiting on the 2nd day of life. At operation, a duplication cyst of the pylorus was removed successfully and a pyloroantrectomy performed.
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Affiliation(s)
- Amar Shah
- Department of Paediatric Surgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B46NH, UK
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24
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Affiliation(s)
- Ruhul Amin Hassan
- Department of Pediatric Surgery & Radiology, Maternity & Childrenś Hospital, Madina Munawara, Saudi Arabia
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Affiliation(s)
- Joel R Lim
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, USA
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26
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Stecevic V, Karim R, Jacobs R. Gastric duplication cyst treated by endoscopic electrosurgical snare resection. Gastrointest Endosc 2003; 57:615-6. [PMID: 12665786 DOI: 10.1067/mge.2003.167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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27
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Tayar C, Brunetti F, Tantawi B, Fagniez PL. [Laparoscopic treatment of an adult gastric duplication cyst]. ANNALES DE CHIRURGIE 2003; 128:105-8. [PMID: 12657549 DOI: 10.1016/s0003-3944(02)00041-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We hereby report the case of a 24 years old woman with an adult gastric duplication cyst, a very rare congenital disease. Diagnosis was established on preoperative imaging tests. Complete resection of the duplication cyst was undertaken laparoscopically. To the best of our knowledge, this is the first report of laparoscopic resection of an adult gastric duplication cyst.
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Affiliation(s)
- C Tayar
- Hôpital Henri-Mondor, université Paris XII, Créteil, France
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28
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Narlawar RS, Rao JR, Karmarkar SJ, Gupta A, Hira P. Sonographic findings in a duodenal duplication cyst. JOURNAL OF CLINICAL ULTRASOUND : JCU 2002; 30:566-568. [PMID: 12404525 DOI: 10.1002/jcu.10117] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We report the sonographic features of a duodenal duplication cyst containing ectopic pancreatic tissue in a 5-month-old boy who presented with symptoms of partial gastric outlet obstruction. Sonography revealed an anechoic, double-walled, bilobed cystic lesion containing debris in the pyloroduodenal region. There was sound through-transmission but no air or communication with the gastrointestinal tract. Surgical resection and histopathologic examination confirmed a duodenal duplication cyst containing pancreatic tissue.
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Affiliation(s)
- Ranjeet S Narlawar
- Department of Radiology, King Edward Memorial Hospital, Parel, Mumbai 400 012, India
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29
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Webster J, Terry S, Humphrey D, Khan SA. Anorexia and pancreatitis associated with a gastric duplication cyst of the pancreas. Surgery 2001; 129:375-6. [PMID: 11231468 DOI: 10.1067/msy.2001.106427] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- J Webster
- Departments of Surgery and Pathology, SUNY Health Science Center at Syracuse, Syracuse, NY, USA
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30
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Ikehata A, Sakuma T. Gastric duplication cyst with markedly elevated concentration of carbohydrate antigen 19-9. Am J Gastroenterol 2000; 95:842-3. [PMID: 10710108 DOI: 10.1111/j.1572-0241.2000.01873.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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31
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 35-1999. A five-month-old girl with coffee-grounds vomitus. N Engl J Med 1999; 341:1597-603. [PMID: 10564691 DOI: 10.1056/nejm199911183412108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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32
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Abstract
The case of a 13-year-old female presenting with a 6 week history of significant vomiting resulting from a gastric duplication is described. At endoscopy, an antral mass which appeared to change in size and site with peristalsis was evident. Although rare, these lesions need to be considered in the differential diagnosis of patients presenting with symptoms suggestive of gastric outlet obstruction. However, in the majority of cases, the diagnosis is rarely made prior to surgery.
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Affiliation(s)
- C S Pokorny
- Specialist Medical Centre, Liverpool, Australia
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33
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Wang KL, Wang HP, Wu MS, Shun CT, Lee PH, Wang TH, Lin JT. Endoscopic ultrasonographic characteristics of a gastric tubular duplication. Gastrointest Endosc 1997; 46:76-9. [PMID: 9260712 DOI: 10.1016/s0016-5107(97)70216-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- K L Wang
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei
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34
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Abstract
BACKGROUND & AIMS Foregut duplication cysts are rare congenital anomalies of enteric origin found most commonly in children and rarely in adults. They are usually found in adults on routine radiological studies and represent a challenging diagnostic problem. Conventional imaging tests do not lead to a conclusive diagnosis. With endoscopic ultrasonography, it is possible to distinguish between cystic and solid masses and to accurately establish the location of the cyst in relation to the gastrointestinal wall and to the mediastinum. METHODS Seven patients who had endoscopic ultrasonography performed because of differentiation between a cystic or solid mass lesion in the chest or abdomen could not be made with conventional radiological methods are described. RESULTS In all patients, a definite diagnosis was established by endoscopic ultrasonography. The diagnosis was confirmed in 2 patients after surgical excision. CONCLUSIONS Surgery can be avoided in patients with asymptomatic enteric duplication cysts diagnosed by endoscopic ultrasonography.
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Affiliation(s)
- A Geller
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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35
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Blais C, Massé S. Preoperative ultrasound diagnosis of a gastric duplication cyst with ectopic pancreas in a child. J Pediatr Surg 1995; 30:1384-6. [PMID: 8523255 DOI: 10.1016/0022-3468(95)90516-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Duplication cysts of the antral and duodenal regions are rare, and small ones are difficult to diagnose preoperatively. The authors present the case of a 4-year-old boy with recurrent bouts of upper gastrointestinal hemorrhage over the previous 2 years. At first, gastroscopy was diagnostic for antral ulcerations, which healed with medical treatment. Chronic blood loss persisted and was associated with abdominal pain. A barium study showed antral deformity, with a suspected mass, which prompted a selective ultrasound examination, during which a 1-cm duplication cyst was detected. Of special interest is the change in shape and content of that cyst, demonstrated sonographically over a 2-month period. In children, high-resolution ultrasonography can be an important step in evaluation of the gastrointestinal tract. Here it showed a small but surgically significant lesion.
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Affiliation(s)
- C Blais
- Department of Radiology, CHU de Sherbrooke, Fleurimont, Quebec, Canada
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36
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Abstract
A newborn baby presented with a lump in the right hypochondrium. She had a bout of upper gastrointestinal bleeding. At operation, a pyloroduedenal duplication cyst was successfully removed. The relevant literature is reviewed.
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Affiliation(s)
- T V Murty
- Department of Surgery, Faculty of Medicine, Arab Medical University, Benghazi, Libya
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37
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Abstract
Gastric duplication cysts are rare. The usual presentation is an abdominal mass with vomiting. In this article we report on a case presenting as an acute abdomen.
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Affiliation(s)
- K Sieunarine
- Cardio-Thoracic Unit, Royal Perth Hospital, Australia
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38
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Hulnick DH, Balthazar EJ. Gastric duplication cyst: GI series and CT correlation. GASTROINTESTINAL RADIOLOGY 1987; 12:106-8. [PMID: 3556968 DOI: 10.1007/bf01885115] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The radiographic and computed tomographic findings of a communicating gastric duplication first diagnosed in a 55-year-old man are presented and the pertinent literature is reviewed.
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39
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Spence RK, Schnaufer L, Mahboubi S. Coexistant gastric duplication and accessory pancreas: clinical manifestations, embryogenesis, and treatment. J Pediatr Surg 1986; 21:68-70. [PMID: 3484784 DOI: 10.1016/s0022-3468(86)80659-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Combined gastric and pancreatic duplications are uncommon. Although patients usually present with symptoms of intestinal obstruction, gastrointestinal (GI) bleeding may occur if the duplication ulcerates and erodes into a neighboring hollow viscus. An upper GI series and barium enema are helpful in making a diagnosis. Combined duplications probably are produced during embryologic development by traction along a neuroenteric band between the stomach and pancreas. Simple surgical excision is the treatment of choice.
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40
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Abstract
Real time ultrasound is an excellent method of detecting cystic lesions in the child's abdomen. Its accuracy in the diagnosis of intestinal duplication cysts is enhanced when it is followed by a barium study. These cysts may present a variety of ultrasonic appearances and the spectrum of findings is well represented by three consecutive cases diagnosed in 1983.
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41
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Abstract
A five-day-old premature infant presented with hyperbilirubinemia, vomiting, and an abdominal mass. At laparotomy a gastric duplication cyst was removed from the pyloric region.
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42
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Abstract
A case of an ectopic gastric duplication cyst that appeared to arise from the pancreas in a 10-week-old infant with a superficial mass in the left upper quadrant is reported. Preoperative ultrasound showed a cystic lesion with an inner echogenic layer (mucosa) and an outer anechoic rim (muscle). Technetium scan demonstrated that there was a gastric-type mucosa in the cyst. It is suggested that the ultrasound findings are specific for a gastric duplication cyst and that ultrasound and technetium scan alone will adequately characterize these lesions preoperatively.
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43
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44
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Floros D, Dosios T, Gourtsoyiannis N, Vyssoulis C. Gastric duplication associated with adenomyoma. J Surg Oncol 1982; 19:98-100. [PMID: 6276617 DOI: 10.1002/jso.2930190211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A case of gastric duplication associated with adenomyoma including ectopic pancreatic tissue in an adult patient is reported. The histologic features, diagnostic criteria, and pathogenesis are briefly discussed.
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45
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O'Reilly K, Green A. A case of gastric duplication in an adult. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1981; 51:367-8. [PMID: 6944057 DOI: 10.1111/j.1445-2197.1981.tb04968.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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