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Jayapal L, Kumar S, Baskaran A, Balachandar TG, Swain SK. Gastric Duplication Cyst: A Report of a Rare Case. Cureus 2023; 15:e40285. [PMID: 37448420 PMCID: PMC10336738 DOI: 10.7759/cureus.40285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Gastric duplication cysts (GDCs) are rare congenital anomalies that primarily occur in childhood but can also manifest in adults. While the ileum is the most common site of duplication, gastric duplications are infrequent. Symptomatic GDCs typically present with upper abdominal pain, vomiting, and occasionally as palpable abdominal masses. Diagnostic imaging, particularly cross-sectional techniques, plays a crucial role in identifying these cysts, and surgical resection is the definitive curative treatment. We report the case of a 44-year-old female who presented with severe right-side upper abdominal pain accompanied by non-bilious vomiting. Initial basic blood investigations yielded normal results. Subsequent contrast-enhanced computed tomography revealed a non-enhancing cystic lesion of size 9x8.5x6.5cm in the left suprarenal region lying posterior to the stomach suggestive of either a GDC or an adrenal cyst. Another hyperdense peripherally enhancing lesion was observed in the right adrenal gland, indicating a right adrenal cyst with internal hemorrhage. During laparotomy, the left side cystic lesion was found arising from the posterior wall of the greater curvature of the stomach, along with another cystic lesion of about 3x3cm originating from the right adrenal gland. Both cystic lesions were successfully excised, and the patient experienced a smooth postoperative recovery without any complications. Histopathological examination confirmed the presence of a cyst lined by gastric-type epithelium with underlying smooth muscle fibers consistent with GDCs. The right adrenal gland cystic lesion exhibited central areas of hemorrhage and necrosis.
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Affiliation(s)
- Loganathan Jayapal
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
| | - Santhosh Kumar
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
| | - Aravind Baskaran
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
| | - T G Balachandar
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
| | - Sudeepta K Swain
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
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Cherouaqi Y, Belabbes F, Allaoui M, Al Bouzidi A, Rouibaa F. Gastric Duplication Cyst Revealed After an Endoscopic Ultrasound-Guided Fine-Needle Aspiration of a Suspected Mucinous Cystadenoma of the Pancreas. Cureus 2021; 13:e19560. [PMID: 34917440 PMCID: PMC8669972 DOI: 10.7759/cureus.19560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/20/2022] Open
Abstract
Gastrointestinal duplication is a rare congenital anomaly of the gastrointestinal tract. Gastric duplication cysts (GDCs) are uncommon in adults, and most cases are discovered incidentally. Here, we report a fortuitous discovery of a rare case of an asymptomatic noncommunicating GDC in an adult revealed after an endoscopic ultrasound-guided fine-needle aspiration of a suspected mucinous cystadenoma of the pancreas. A 34-year-old female presented with renal colic. Her abdominal examination was normal. She presented a cystic image at the left lumbar discovered fortuitously during ultrasonography. On uro-computed tomography, there was a suspicion of a pancreatic cystadenoma. Magnetic resonance imaging of the pancreas suggested a mucinous cystadenoma of the pancreatic tail. The endoscopic ultrasound showed a cystic thick-walled formation in the tail of the pancreas. After guided fine-needle aspiration, a split aspect of the gastric wall appeared evoking a GDC. The cytology showed epithelial cells without mucin. Three years later, the patient does not have any gastrointestinal symptoms. GDCs are a rare anomaly, and accurate diagnosis of these cysts is difficult. Surgical resection can offer a definitive diagnosis. The mainstay of treatment is surgery to avoid the risk of malignancy.
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Rahul S, Keshri R, Prasad R, Chaubey D, Hasan Z, Kumar V, Thakur V, Yadav R, Kumar R, Bakhtiyar A. Duplications of the alimentary tract in infants and children. FORMOSAN JOURNAL OF SURGERY 2021. [DOI: 10.4103/fjs.fjs_137_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mirza MB, Shahzad A, Mahmood N, Imran A, Hussain M, Fayyaz Z, Talat N. Complicated gastric duplication cyst presenting as cystic intraperitoneal collection: a case report. ANNALS OF PEDIATRIC SURGERY 2020. [DOI: 10.1186/s43159-020-00063-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Alimentary tract duplications are rare anomalies and any delay in the diagnosis may develop various complications. Infection, hemorrhage, or perforation of the duplication cyst may lead to an acute presentation. Occasionally, it may lead to a diagnostic and management dilemma. Herein, we report an unusual complication of gastric duplication cyst.
Case presentation
A 2.5-year-old girl presented with recurrent abdominal distension, fever, and abdominal pain. The imaging workup revealed a huge intraperitoneal collection. Intraoperatively, a huge pseudocyst was encountered communicating with the gastric duplication cyst. The gastric duplication cyst was sharing a common wall with the greater curvature of the stomach but was not communicating with the gastric lumen. Pseudocyst along with gastric duplication cyst was completely excised. The resultant seromuscular defect of the stomach was also closed. The postoperative period was uneventful.
Conclusion
Perforation of the gastric duplication cyst should be kept in differentials of intraperitoneal collection not amenable to multiple aspirations. Huge intraperitoneal collection secondary to perforation of gastric duplication is exceedingly rare and scarcely reported in the literature.
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Makhija D, Shah H, Tiwari C, Jayaswal S. Gastric duplication cyst with hemoptysis: an unusual presentation. Turk Arch Pediatr 2019; 53:255-258. [PMID: 30872929 DOI: 10.5152/turkpediatriars.2018.4176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 11/02/2016] [Indexed: 11/22/2022]
Abstract
Gastrointestinal duplications are rare developmental anomalies that may occur at any level from the oral cavity to the rectum, with the ileum being the most common site. Gastric duplications are rare gastrointestinal duplications. Various theories have been proposed for the development of duplication cysts; however, there is no single theory that explains all types of duplications. Complete removal is the treatment of choice to avoid the risk of possible complications and malignant transformation. Most cases present within the first year of life. The clinical presentation of gastric duplications can be highly variable; however, they usually present with abdominal pain and a lump. Clinical presentation with hemoptysis is rare. Only one such case has been reported previously. We describe a three-year-old male with gastric duplication who presented with hemoptysis.
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Affiliation(s)
- Deepa Makhija
- TNMC&BYL Nair Hastanesi, Çocuk Cerrahisi Bölümü, Mumbai, Hindistan
| | - Hemanshi Shah
- TNMC&BYL Nair Hastanesi, Çocuk Cerrahisi Bölümü, Mumbai, Hindistan
| | - Charu Tiwari
- TNMC&BYL Nair Hastanesi, Çocuk Cerrahisi Bölümü, Mumbai, Hindistan
| | - Shalika Jayaswal
- TNMC&BYL Nair Hastanesi, Çocuk Cerrahisi Bölümü, Mumbai, Hindistan
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Abstract
Gastric duplication cysts are an uncommon finding, especially in the adult population. Presenting symptoms can be non-specific, but can include abdominal pain, nausea and emesis. In this report, we present a 28-year-old female diagnosed with a communicating gastric cyst with both gastric and duodenal mucosa, along with pancreatic tissue and no evidence of dysplasia or malignancy. The clinical picture, diagnosis and treatment are described and compared to findings in the literature.
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Affiliation(s)
- Matthew P Doepker
- Department of Surgical Oncology, Moffitt Cancer Center, Tampa, FL, USA,
| | - Syed A Ahmad
- Department of Surgery, The University of Cincinnati Medical Center, Cincinnati, OH, USA
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Biebl M, Hechenleitner P, Renz O, Häussler B, Sanal M. Laparoscopic resection of multiple gastric duplication cysts in an 8 year-old boy. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2015. [DOI: 10.1016/j.epsc.2015.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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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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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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Abstract
CONTEXT Pulmonary hemorrhage and hemoptysis are uncommon in childhood, and the frequency with which they are encountered by the pediatrician depends largely on the special interests of the center to which the child is referred. Diagnosis and management of hemoptysis in this age group requires knowledge and skill in the causes and management of this infrequently occurring potentially life-threatening condition. EVIDENCE ACQUISITION We reviewed the causes and treatment options for hemoptysis in the pediatric patient using Medline and Pubmed. RESULTS A focused physical examination can lead to the diagnosis of hemoptysis in most of the cases. In children, lower respiratory tract infection and foreign body aspiration are common causes. Chest radiographs often aid in diagnosis and assist in using two complementary diagnostic procedures, fiberoptic bronchoscopy and high-resolution computed tomography. The goals of management are threefold: bleeding cessation, aspiration prevention, and treatment of the underlying cause. Mild hemoptysis often is caused by an infection that can be managed on an outpatient basis with close monitoring. Massive hemoptysis may require additional therapeutic options such as therapeutic bronchoscopy, angiography with embolization, and surgical intervention such as resection or revascularization. CONCLUSIONS Hemoptysis in the pediatric patient requires prompt and thorough evaluation and treatment. An efficient systematic evaluation is imperative in identifying the underlying etiology and aggressive management is important because of the potential severity of the problem. This clinical review highlights the various etiological factors, the diagnostic and treatment strategies of hemoptysis in children.
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Affiliation(s)
- G S Gaude
- Department of Pulmonary Medicine, JN Medical College, Belgaum, Karnataka, India.
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Wakabayashi H, Okano K, Yamamoto N, Suzuki Y, Inoue H, Kadota K, Haba R. Laparoscopically resected foregut duplication cyst (bronchogenic) of the stomach. Dig Dis Sci 2007; 52:1767-70. [PMID: 17404869 DOI: 10.1007/s10620-006-9580-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 08/17/2006] [Indexed: 12/17/2022]
Affiliation(s)
- Hisao Wakabayashi
- Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan.
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Espeso A, Verma S, Jani P, Sudhoff H. Mediastinal foregut duplication cyst presenting as a rare cause of breathing difficulties in an adult. Eur Arch Otorhinolaryngol 2007; 264:1357-60. [PMID: 17594109 DOI: 10.1007/s00405-007-0364-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2007] [Accepted: 05/23/2007] [Indexed: 12/29/2022]
Abstract
Foregut duplication cysts are rare congenital anomalies of enteric origin. The diagnosis is usually made in infancy. We report the unusual case of a 71-year-old female presenting to the ENT department with shortness of breath and stridor due to an oesophageal reduplication cyst. The presentation, diagnosis and management of this potential pitfall for the unwary are outlined.
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Affiliation(s)
- A Espeso
- Department of Otolaryngology and Skull Base Surgery, Addenbrooke's Hospital, Cambridge, UK.
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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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