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Nwakor S, Reinshagen K, Suß J, Jürgens J, Wenke K, Tomuschat C. Congenital gastric duplication cyst: A case report of a 36 day-old girl. Z Geburtshilfe Neonatol 2025. [PMID: 40185151 DOI: 10.1055/a-2563-1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2025]
Abstract
Duplications of the gastrointestinal tract exist in various forms and present differently depending on their location. They are extremely rare congenital malformations, and especially duplication cysts of the pyloric channel are among the rarest. They appear with a variety of symptoms, above all with severe vomiting. To date a surgical resection seems to be the only effective treatment. In order to share our experience with a congenital gastric duplication cyst, we present the case of a 36-day-old girl.
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Affiliation(s)
- Simon Nwakor
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Konrad Reinshagen
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joachim Suß
- Department of Pediatric Surgery, Catholic Childrens Hospital Wilhelmstift, Hamburg, Germany
| | - Julian Jürgens
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Wenke
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Tomuschat
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Takeda T, Danno K, Fukata T, Nakamichi I, Yamamoto K, Higashiguchi M, Noguchi K, Hirao T, Sekimoto M, Oka Y. Adult Cystic Intestinal Duplication of the Ileum Laparoscopically Resected after Preoperative Diagnosis with Cine Magnetic Resonance Imaging and Abdominal Ultrasound: A Case Report. Surg Case Rep 2025; 11:25-0015. [PMID: 40196212 PMCID: PMC11973249 DOI: 10.70352/scrj.cr.25-0015] [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] [Received: 01/15/2025] [Accepted: 03/17/2025] [Indexed: 04/09/2025] Open
Abstract
INTRODUCTION Small bowel duplication in adults is an uncommon congenital anomaly that often presents with nonspecific symptoms, such as abdominal pain, vomiting, or constipation, which complicates diagnosis. Imaging techniques such as computed tomography (CT) and ultrasonography are commonly used, and cine magnetic resonance imaging (MRI) has emerged as a promising modality for diagnosing duplication cysts by capturing peristaltic movements. Surgical resection is the definitive treatment for preventing complications such as obstruction, infection, or malignant transformation. CASE PRESENTATION A woman in her thirties visited the emergency department with persistent lower abdominal pain. Physical examination and laboratory tests, including those for tumor markers, were unremarkable. CT revealed a cystic mass near the uterus, and pelvic MRI revealed a cystic lesion that had migrated during follow-up imaging. Cine MRI showed peristaltic movements within the lesion, and abdominal ultrasonography confirmed a cystic structure with wall movements resembling intestinal peristalsis. Based on these findings, the diagnosis of a noncommunicating small bowel duplication cyst was made.The patient underwent a laparoscopic single-port partial resection of the ileum. A cystic lesion located 75 cm proximal to the terminal ileum was excised along with a segment of the small intestine. Histopathological examination revealed a duplicated cyst lined with the small intestinal mucosa, confirming the diagnosis. The postoperative course was uneventful, and the patient was discharged 1 week postoperatively. CONCLUSION This case highlights the utility of cine MRI and ultrasonography in the preoperative diagnosis of small bowel duplication cysts. In particular, cine MRI provides dynamic visualization of peristaltic movements within the cyst, enabling a confident diagnosis. The migration of the cyst observed on serial MRI examinations further corroborated the origin of this duplication. These findings emphasize the importance of advanced imaging modalities in the diagnosis of rare intestinal anomalies. Preoperative diagnosis of small bowel duplication cysts can be significantly enhanced by using cine MRI and ultrasonography to detect peristaltic movements. These modalities offer critical insights that aid timely surgical intervention and improve outcomes.
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Affiliation(s)
- Takashi Takeda
- Department of Surgery, Minoh City Hospital, Minoh, Osaka, Japan
| | - Katsuki Danno
- Department of Surgery, Minoh City Hospital, Minoh, Osaka, Japan
| | - Tadafumi Fukata
- Department of Surgery, Minoh City Hospital, Minoh, Osaka, Japan
| | - Itsuko Nakamichi
- Department of Pathology, Minoh City Hospital, Minoh, Osaka, Japan
| | - Kei Yamamoto
- Department of Surgery, Minoh City Hospital, Minoh, Osaka, Japan
| | | | - Kozo Noguchi
- Department of Surgery, Minoh City Hospital, Minoh, Osaka, Japan
| | - Takafumi Hirao
- Department of Surgery, Minoh City Hospital, Minoh, Osaka, Japan
| | | | - Yoshio Oka
- Department of Surgery, Minoh City Hospital, Minoh, Osaka, Japan
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Akıncı SM, Boybeyi Ö, Orhan D, Soyer T. Variations in Epithelial Lining of Duplication Cysts Cannot be Explained by Known Theories. Int J Surg Pathol 2025; 33:384-388. [PMID: 39152625 DOI: 10.1177/10668969241265041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
Objectives. Duplication cysts are found in any part of the gastrointestinal tract from the oropharynx to anus. Although duplication cysts usually have similar epithelium with the adjacent organ, respiratory epithelium in the enteric duplication cysts is rarely reported. This study was performed to evaluate the variations in the epithelial lining of duplication cysts and its clinical implications. Methods. Patients diagnosed with duplication cysts between 2012 and 2022 were retrospectively reviewed to assess their histopathological results, clinical aspects, treatment options, and demographic characteristics. Results. Twenty-five patients were included. The mean age was 4 years, male-to-female ratio was 15:10. The localizations of duplication cysts were ileum (n = 12), duodenum(n = 4), stomach(n = 3), jejunum(n = 2), colon(n = 2), thoracoabdominal(n = 2), and rectum(n = 1). Most common presentation was abdominal pain (36%). Intestinal (48%) and gastric (40%) epithelia were the most common finding. Four patients (16%) had respiratory epithelium: two in foregut duplication cysts, one each in ileal, and rectal duplications. Twenty-four percentage of patients had associated anomalies. Surgical interventions were performed on 22 patients. Conclusion. Duplication cysts show a wide range of epithelial linings. Respiratory epithelium can be found in not only foregut duplication cysts but also midgut and hindgut duplication cysts. Although the presence of respiratory epithelium did not have any impact on clinical findings, none of the previous theories explain the presence of respiratory epithelium different from foregut duplications.
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Affiliation(s)
- Servet Melike Akıncı
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkiye
| | - Özlem Boybeyi
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkiye
| | - Diclehan Orhan
- Department of Pediatric and Perinatal Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkiye
| | - Tutku Soyer
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkiye
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Wang M, Wang L, Chen Y, Qian Y, Chen Q. Clinical Characteristics and Treatment of Gastric Duplications in Children. J Pediatr Surg 2025; 60:162115. [PMID: 39729917 DOI: 10.1016/j.jpedsurg.2024.162115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 12/15/2024] [Accepted: 12/15/2024] [Indexed: 12/29/2024]
Abstract
BACKGROUND Gastric duplication (GD) is a rare congenital gastrointestinal malformation, and usually identified in childhood. This study aimed to investigate the clinical characteristics and treatment of GDs in children. METHODS A retrospective review was conducted of medical records of 38 patients with the diagnosis of GD, treated in the Department of General Surgery, Children's Hospital of Zhejiang University School of Medicine, within the period from August 2013 to December 2023. Patients treated with laparoscopic conversion to open procedures, complete laparoscopic procedures, or robot-assisted procedures. RESULTS There were 23 males and 15 females. All cases were cystic, and all but one had no communication with gastric lumen. Ten cases (26.3 %) were symptomatic, 18 (47.4 %) were detected prenatally and 10 (26.3 %) were detected by examination. Patients diagnosed prenatally were treated much earlier (1.1 (0.2-1.6) years VS 6.4 (2.2-9.8) years; P < 0.001) and have a much lower incidence of symptoms (0 VS 50 %; P < 0.001) than those diagnosed postnatal. Twenty-one patients underwent laparoscopic exploration, which consist of the laparoscopy converted to open procedures group (LOG, n = 9), and complete laparoscopic procedures group (LG, n = 12). Robot-assisted procedures group (RG) including 17 patients. There was no significant difference in patients' age, weight, operation time, the postoperative fasting duration and postoperative complications between the three groups (P > 0.05). The estimated intraoperative blood loss was the highest in LOG (10 (7.5-10) ml), followed by LG (4 (2-5) ml), and RG (2 (1-2) ml) was the lowest. The postoperative hospital stay was shorter in the RG (6 (6-8)) than in the LOG (11 (7.5-12.5)), and there was no significant difference between the other two groups. The RG had a significantly higher hospitalization cost (P < 0.05) than other two groups. CONCLUSIONS Gastric duplication in children is rare, and has no specific clinical manifestations. Most cases were diagnosed prenatally and can be diagnosed and treated early after birth. Robot-assisted procedure can achieve good therapeutic effects, with less blood loss and low conversion rate to open procedure. TYPE OF STUDY Retrospective Comparative Study. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Meiyan Wang
- Chun'an First People's Hospital, Hangzhou, China
| | - Linyan Wang
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
| | - Yi Chen
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yunzhong Qian
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Qingjiang Chen
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Nomura Y, Nagayama S, Fujioka S, Takeuchi G, Takeuchi Y, Okamoto M, Ganeko R, Nakayama Y, Hashimoto K, Kubota Y. Two Cases of Adult-Onset Intestinal Duplication Manifested as Acute Abdomen: Case Report and Review of the Literature. Surg Case Rep 2025; 11:24-0023. [PMID: 40008372 PMCID: PMC11850214 DOI: 10.70352/scrj.cr.24-0023] [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] [Received: 10/15/2024] [Accepted: 01/06/2025] [Indexed: 02/27/2025] Open
Abstract
INTRODUCTION Gastrointestinal duplication is a rare congenital anomaly, usually occurring in childhood and rarely in adults. It is most common in the ileum, but can occur anywhere in the gastrointestinal tract from the mouth to the anus. An adult case of intestinal duplication is accompanied by non-specific symptoms and, hence, it is often difficult to establish accurate diagnosis preoperatively in adults. CASE PRESENTATION We experienced two cases of ileal duplication that was manifested as acute abdomen. In both cases, we performed emergency surgery with a tentative preoperative diagnosis of perforation peritonitis related to intestinal duplication. The first case was a 36-year-old male presenting with a cystic non-communicating intestinal duplication, which was perforated, causing abdominal pain. The second case was a 77-year-old male presenting with tubular communicating intestinal duplication, in which a fecal stone was fitted into the root of the duplicated intestine, and the duplicated intestine itself became abscessed, causing abdominal pain. Their postoperative courses were uneventful and the patients were discharged from hospital without any sequelae on the 5th and 10th postoperative day, respectively. CONCLUSION Although preoperative diagnosis is not easy, because the clinical presentation varies depending on the occurrence site, in-depth evaluation of preoperative CT images could lead to a precise diagnosis especially when considering intestinal duplication as one of the differential diagnoses of acute abdomen.
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Affiliation(s)
- Yuki Nomura
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Satoshi Nagayama
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Sachie Fujioka
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Go Takeuchi
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Yuma Takeuchi
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Michio Okamoto
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Riki Ganeko
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Yusuke Nakayama
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Kyoichi Hashimoto
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Yoshihiro Kubota
- Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
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Sharma A, Drachtman R, Paneque AM, Maddali V. Paraneoplastic Autoimmune Hemolytic Anemia Secondary to a Gastric Duplication Cyst in a 15-Month-Old Girl: A Case Report and Review of the Literature. Cureus 2024; 16:e75949. [PMID: 39830564 PMCID: PMC11740924 DOI: 10.7759/cureus.75949] [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: 12/17/2024] [Indexed: 01/22/2025] Open
Abstract
Gastric duplication is a rare congenital disorder of the alimentary tract, and anemia is a rare presenting clinical sign of gastric duplication cysts (GDC). There are two reported cases of autoimmune hemolytic anemia as a paraneoplastic presentation of gastric duplication in the adult population, but there have not yet been any reported cases of this in childhood. We report the first case in the pediatric patient population: the case of GDC presenting as autoimmune hemolytic anemia in a 15-month-old girl.
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Affiliation(s)
- Archana Sharma
- Pediatric Hematology, Robert Wood Johnson University Hospital, New Brunswick, USA
| | - Richard Drachtman
- Pediatric Hematology, Robert Wood Johnson University Hospital, New Brunswick, USA
| | - Alysta M Paneque
- Medicine, Robert Wood Johnson Medical School, New Brunswick, USA
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Uzunkulaoglu M, Uge BN, Düzköylü Y, Dursun Kepkep N, Yardimci AH. An Isolated Enteric Duplication Cyst With Mucinous Neoplasm Presenting as a Mesenteric Cyst: A Case Report. Cureus 2024; 16:e72482. [PMID: 39600750 PMCID: PMC11594363 DOI: 10.7759/cureus.72482] [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: 10/27/2024] [Indexed: 11/29/2024] Open
Abstract
Enteric duplication cysts (EDCs) are infrequent intraabdominal lesions, though they can be detected anywhere throughout the gastrointestinal tract. Rarely, they can be asymptomatic and encountered in adulthood. Completely isolated EDCs are rarer with malignant transformation inside the cyst. Herein, we report a unique case of a mucinous neoplasm that developed in an isolated EDC in an adult patient treated with surgical resection and provide detailed radiological and histopathological findings.
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Affiliation(s)
- Mert Uzunkulaoglu
- General Surgery, Başakşehir Çam and Sakura City Hospital, Istanbul, TUR
| | - Buse Nur Uge
- Pathology, Başakşehir Çam and Sakura City Hospital, Istanbul, TUR
| | - Yiğit Düzköylü
- Gastroenterological Surgery, Başakşehir Çam and Sakura City Hospital, Istanbul, TUR
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8
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Yun SM, Yeom JA, Lee JW, Kim GH, Nam KJ, Jeong YJ. Findings of Endoscopic US and CT of Esophageal Disease. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2024; 85:883-901. [PMID: 39416323 PMCID: PMC11473974 DOI: 10.3348/jksr.2023.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/03/2024] [Accepted: 03/05/2024] [Indexed: 10/19/2024]
Abstract
Various diseases can affect the esophagus. Endoscopic ultrasound (EUS), which provides precise information about the layers of the esophageal wall, is the primary approach used to investigate esophageal diseases. However, CT is one of the most important imaging modalities for diagnosing esophageal diseases as it can elucidate mediastinal involvement, adjacent lymphadenopathy, and distant disease spread. These two modalities complement each other in the diagnosis of esophageal diseases. Although radiologists may be unfamiliar with EUS procedures and their interpretation, understanding them aids in the differential diagnosis of esophageal conditions. This pictorial essay illustrates the EUS and CT findings of various esophageal diseases originating in the esophageal wall.
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Chait F, Bahlouli N, Faraj C, Essetti S, Alaoui NM, Alami N, El basri B, Erraimi N, Alhamany Z, Allali N, El Haddad S, Chat L. Late presentation of gastric duplication cyst in pediatric patient: Lessons learned. Radiol Case Rep 2024; 19:3400-3404. [PMID: 38827040 PMCID: PMC11140142 DOI: 10.1016/j.radcr.2024.04.057] [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] [Received: 12/26/2023] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 06/04/2024] Open
Abstract
Gastrointestinal duplication is an infrequent congenital disorder characterized by the presence of a muscular layer covered by mucosa. Gastric duplication cysts account for approximately 2%-9% of all gastrointestinal duplication cysts. The typical clinical presentation often includes symptoms such as epigastric pain, vomiting, and the presence of a palpable abdominal mass. However, these symptoms can overlap with more common conditions. Diagnostic confirmation usually necessitates additional imaging studies, and surgical intervention is the recommended treatment approach. In this case report, we present the case of a 9-year-old girl who presented with chronic abdominal pain and vomiting. Following a comprehensive evaluation, including a CT scan and various diagnostic tests, a diagnosis of gastric duplication cyst was established. The patient subsequently underwent a laparotomy procedure, during which the cyst was completely excised. Follow-up visits indicated an uneventful recovery, with complete resolution of all symptoms. The aim of this work is to report on the clinico-radiological aspects of gastric duplication cysts and their surgical treatment.
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Affiliation(s)
- Fatima Chait
- Pediatric radiology department, Pediatric Teaching Hospital, Mohammed V University, Rabat Morocco
| | - Nourrelhouda Bahlouli
- Pediatric radiology department, Pediatric Teaching Hospital, Mohammed V University, Rabat Morocco
| | - Chaymae Faraj
- Pediatric radiology department, Pediatric Teaching Hospital, Mohammed V University, Rabat Morocco
| | - Sara Essetti
- Pediatric radiology department, Pediatric Teaching Hospital, Mohammed V University, Rabat Morocco
| | - Nidal Mrani Alaoui
- Departement of pediatrics, Cheikh Zayd Hospital, Av. Allal Al Fassi, Rabat 10000, Morocco
| | - Narjiss Alami
- Departement of pediatrics, Cheikh Zayd Hospital, Av. Allal Al Fassi, Rabat 10000, Morocco
| | - Bouchra El basri
- Departement of pediatrics, Cheikh Zayd Hospital, Av. Allal Al Fassi, Rabat 10000, Morocco
| | - Naima Erraimi
- Departement of pediatrics, Cheikh Zayd Hospital, Av. Allal Al Fassi, Rabat 10000, Morocco
| | - Zaitouna Alhamany
- Anatomo-pathological department, Cheikh Zayd Hospital, Av. Allal Al Fassi, Rabat 10000, Morocco
| | - Nazik Allali
- Pediatric radiology department, Pediatric Teaching Hospital, Mohammed V University, Rabat Morocco
| | - Siham El Haddad
- Pediatric radiology department, Pediatric Teaching Hospital, Mohammed V University, Rabat Morocco
| | - Latifa Chat
- Pediatric radiology department, Pediatric Teaching Hospital, Mohammed V University, Rabat Morocco
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Rubesova E, Moeremans M. MR Imaging of the Fetal Gastrointestinal Anomalies. Magn Reson Imaging Clin N Am 2024; 32:489-496. [PMID: 38944436 DOI: 10.1016/j.mric.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Fetal MR imaging has been shown to be a useful tool for the diagnosis of fetal gastro-intestinal pathologies. To recognize the various pathologies, it is, however, essential to know the normal MR imaging appearance of the fetal bowel at various gestational ages. By providing additional information to ultrasound in case of a fetal gastrointestinal anomaly, MR imaging helps to improve planning for the delivery, postnatal management, and improves parental counseling.
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Affiliation(s)
- Erika Rubesova
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, 725 Welch Road, Palo Alto, CA 94304, USA.
| | - Marine Moeremans
- Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, 725 Welch Road, Palo Alto, CA 94304, USA
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Miyamoto S, Ishii Y, Serikawa M, Tatsukawa Y, Nakamura S, Ikemoto J, Tamura Y, Uemura K, Arihiro K, Oka S. A case of young male with recurrent acute pancreatitis caused by an intrapancreatic gastric duplication cyst. Clin J Gastroenterol 2024; 17:742-747. [PMID: 38536603 PMCID: PMC11284191 DOI: 10.1007/s12328-024-01957-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/13/2024] [Indexed: 07/29/2024]
Abstract
Gastric duplication cyst (GDC) is a rare gastrointestinal malformation that frequently occurs in the greater curvature of the gastric antrum or corpus. Herein, we reported a case of intrapancreatic GDC found as a result of recurring pancreatitis. A 15-year-old man experienced repeated episodes of acute pancreatitis and was found to have a cystic lesion in the pancreatic tail. Contrast-enhanced computed tomography revealed a 20-mm cystic lesion with an enhanced thick wall. Endoscopic ultrasonography revealed an anechoic cyst with a three-layered wall. Magnetic resonance cholangiopancreatography and endoscopic retrograde pancreatography (ERP) revealed a connection between the cyst and the main pancreatic duct (MPD), and the duplication of the MPD. ERP showed the pancreatic duct stenosis downstream of the cyst. Although preoperative diagnosis was difficult, distal pancreatectomy was performed to prevent recurrence of pancreatitis. Pathological examination revealed that the cystic lesion was circumferentially surrounded by the pancreatic parenchyma. The epithelial lining of the cyst was crypt epithelium containing the fundic or pyloric glands and surrounded by a smooth muscle layer. The final diagnosis was intrapancreatic GDC.
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Affiliation(s)
- Sayaka Miyamoto
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Yasutaka Ishii
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
| | - Masahiro Serikawa
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Yumiko Tatsukawa
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Shinya Nakamura
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Juri Ikemoto
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Yosuke Tamura
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Kenichiro Uemura
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shiro Oka
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
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12
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Dnyanmote AS, Patil K, Kanani R, Modi V. Ileocecal Duplication Cyst Masked by Appendicitis: A Surgeon's Eternal Dilemma. Cureus 2024; 16:e62829. [PMID: 39036257 PMCID: PMC11260395 DOI: 10.7759/cureus.62829] [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: 06/21/2024] [Indexed: 07/23/2024] Open
Abstract
Alimentary tract duplications are uncommon abnormalities. They are mostly found in the terminal ileum, and most develop symptoms before the age of two. Abdominal mass, intestinal blockage, intussusception, rectal hemorrhage, and abdominal pain are possible presenting signs. Intra-abdominal duplications are typically discovered during surgical examinations of the problems; preoperative diagnosis is typically challenging. Our unusual adult male patient, age 32, had an asymptomatic ileal-caecal junction duplication cyst that was linked to a non-complicated acute appendicitis.
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Affiliation(s)
| | - Kuldip Patil
- General Surgery, Dr DY Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Rushi Kanani
- General Surgery, Dr DY Patil Medical College, Hospital and Research Centre, PUNE, IND
| | - Vidita Modi
- Surgery, Dr DY Patil Medical College, Hospital and Research Centre, Pune, IND
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Zaiem A, Atri S, Fteriche FS, Frikha W, Haddad A, Kacem M. Ileal duplication in adults: A rare case. Int J Surg Case Rep 2024; 118:109606. [PMID: 38615468 PMCID: PMC11033146 DOI: 10.1016/j.ijscr.2024.109606] [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: 02/01/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Intestinal duplication is an uncommon congenital malformation affecting the alimentary tract. This article presents a case of enteric duplication cyst (EDC) in an adult, accompanied by a review of the available literature. CASE PRESENTATION A 34-year-old woman with polymyositis underwent a routine CT scan as part of her medical assessment revealing an 8 cm mass near the caecum and terminal ileum. Diagnostic procedures confirmed a cystic spherical mass. The patient underwent ileo-cecal resection, with primary anastomosis and an uneventful recovery. CLINICAL DISCUSSION Studies indicate that the frequency of polymyositis coexisting with a neoplasm range from 6 % to 40 %. Therefore, a body CT scan is recommended for patients with myopathy as in our patient. Intestinal duplications are predominantly found in children but can also occur in adults, often discovered incidentally or due to complications. Diagnostic imaging techniques, such as ultrasonography and CT scan, are crucial in identifying duplication location and characteristics. In this case, colonoscopy indicated ileocecal valve compression, and histological examination confirmed an enteric duplication cyst with ectopic gastric mucosa. CONCLUSION Enteric duplication cysts are rare, and the existing literature on the topic somewhat limited. Early diagnosis and surgical intervention are essential to stave off potential complications and reduce morbidity. Clinician awareness of enteric duplication cysts enables timely management, enhancing patient outcomes. Further research is needed to improve understanding and optimize patient care.
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Candussi IL, Petecariu A, Lungu M, Busila C, Mihailov R, Neagu A, Lungu CN, Sarbu I, Ciongradi CI. Giant Intraabdominal Lymphangioma in a Pediatric Patient-A Challenging Diagnosis. Clin Pract 2024; 14:739-748. [PMID: 38804391 PMCID: PMC11130835 DOI: 10.3390/clinpract14030059] [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: 03/13/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction: Intra-abdominal cystic formations represent heterogeneous pathologies with varied localization and clinical manifestation. The first challenge of a giant intra-abdominal cystic lesion is identifying the organ of origin. The clinical presentation of intra-abdominal cystic lesions varies from acute manifestations to non-specific symptoms or accidental discovery. Case presentation: A 2-year-old girl presents to the emergency unit with a fever of 38.5 Celsius, loss of appetite, and apathy. The investigations showed a gigantic intra-abdominal mass whose organ belonging could not be specified. Postoperatively, a giant mesenteric lymphangioma was evident, which was completely excised. Discussion: Giant cystic formations modify the anatomical reports and become space-replacing formations, and the starting point is even more challenging to assess preoperatively. Nevertheless, the careful evaluation of the characteristics of the formation, the effect on the adjacent organs, the age of the patient, and the clinical picture can provide elements of differential diagnosis. The stated purpose of this work is to systematize intra-abdominal lesions according to the organ of origin and to make the preoperative diagnosis of an intra-abdominal cystic lesion in the pediatric patient easy to perform starting from the presented case.
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Affiliation(s)
- Iuliana-Laura Candussi
- Department of Pediatric Surgery, Clinical Country Children Emergency Hospital, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800010 Galati, Romania; (I.-L.C.); (A.P.); (M.L.); (C.B.)
| | - Alexandru Petecariu
- Department of Pediatric Surgery, Clinical Country Children Emergency Hospital, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800010 Galati, Romania; (I.-L.C.); (A.P.); (M.L.); (C.B.)
| | - Mirela Lungu
- Department of Pediatric Surgery, Clinical Country Children Emergency Hospital, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800010 Galati, Romania; (I.-L.C.); (A.P.); (M.L.); (C.B.)
| | - Camelia Busila
- Department of Pediatric Surgery, Clinical Country Children Emergency Hospital, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800010 Galati, Romania; (I.-L.C.); (A.P.); (M.L.); (C.B.)
| | - Raul Mihailov
- Department of Surgery, Clinical Country Emergency Hospital, 800578 Galati, Romania;
| | - Anca Neagu
- Department of Pathology, Clinical Country Children Emergency Hospital, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800010 Galati, Romania;
| | - Claudiu N. Lungu
- Department of Functional and Morphological Science, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800010 Galati, Romania
| | - Ioan Sarbu
- 2nd Department of Surgery—Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
| | - Carmen I. Ciongradi
- 2nd Department of Surgery—Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
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15
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Jaweesh S, Jaweesh M, Alokla H, Hadaya M, Aljmaz H, Mahgaa MT. A rare case of enteric duplication cyst in the cecum of a 7-year-old child: Case report. Int J Surg Case Rep 2024; 115:109205. [PMID: 38215578 PMCID: PMC10821623 DOI: 10.1016/j.ijscr.2023.109205] [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: 11/21/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION AND SIGNIFICANCE Duplication of the digestive tract is a rare condition, especially when it is located in the cecum. In most cases, it is asymptomatic. The cystic pattern is the most common type of duplication of the digestive tract. The exact cause of this anomaly has not been determined yet. CASE PRESENTATION We present the case of a girl who was suffering from vague abdominal pain for a period of time without response to medical treatment. She was later diagnosed with a duplication cyst of the cecum, which was completely resected with a ileocolic anastomosis. CLINICAL DISCUSSION Surgery is generally the mainstay of treatment for duplication cysts of the digestive tract. Even in asymptomatic cases, surgical resection is preferred to avoid complications and the risk of malignant transformation. CONCLUSION It is always important to consider duplication of the digestive tract as a possible differential diagnosis for cysts in the cecum, and to avoid attempting to dissect the cyst away from the adjacent digestive tract.
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Affiliation(s)
- Shkri Jaweesh
- Faculty of Medicine, Al-Sham Private University, Damascus, Syria.
| | | | - Hasan Alokla
- Faculty of Medicine, Al-Sham Private University, Damascus, Syria
| | - Mahmoud Hadaya
- Faculty of Medicine, Al-Sham Private University, Damascus, Syria
| | - Hussien Aljmaz
- Faculty of Medicine, Al-Sham Private University, Damascus, Syria
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16
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Kim K, Kim J, Kim H. Case report: Surgical management of ileal duplication cyst in a cat: a case report and review of the literature. Front Vet Sci 2023; 10:1323088. [PMID: 38169649 PMCID: PMC10758454 DOI: 10.3389/fvets.2023.1323088] [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] [Received: 10/17/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
A 6-year-old castrated, mixed breed cat presented with vomiting, anorexia, and lethargy. Ultrasonography and computed tomography revealed a round, well-marginated structure closely associated with the ileum proximal to the ileocolic junction. Exploratory laparotomy revealed a mass originating from the distal end of the ileum, close to the ileocolic junction. The mass did not interact with the intestinal lumen. Excisional biopsy with omentalization was performed without small intestinal resection to preserve the ileocolic junctions. Histopathological examination confirmed the presence of an enteric duplication cyst. The cat recovered uneventfully from surgery and remained asymptomatic postoperatively. No recurrence was identified 4 months after surgery. Enteric duplication cysts are uncommon congenital anomalies that originate in the gastrointestinal tract. They could either be communicating or non-communicating with the intestinal lumen. Enteric duplication cysts can be symptomatic or asymptomatic. Enteric duplication cysts associated with the esophagus, duodenum, and jejunum have also been reported in cats. However, to the best of our knowledge, this is the first reported case of an enteric duplication cyst in the feline ileum. Thus, enteric duplication should be considered a differential diagnosis in cystic masses of the ileum.
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Affiliation(s)
- Kihoon Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
| | - Jaehwan Kim
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
| | - Hwiyool Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
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17
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Sah RP, Bhusal A, Pokhrel S, Yogi TN, Labh S, Acharya K, Pokharel S, Bhattarai M. Jejunal duplication cyst in a female neonate: a case report. Ann Med Surg (Lond) 2023; 85:5724-5727. [PMID: 37915628 PMCID: PMC10617856 DOI: 10.1097/ms9.0000000000001303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/05/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction and importance Duplications are the abnormal portion of the intestine, either externally attached to the intestine or intrinsically placed within the bowel lumen. Their prevalence is noted to be around one in 25 000 deliveries. The rare gastrointestinal tract duplication may be located in any part of the gastrointestinal system from the oral cavity to the anus. The most common site of enteric duplication cyst (DC) is the terminal part of the ileum. Hence, duplications in jejunum are rare. Case presentation Hereby, the authors report a case of jejunal DC in a female neonate which was managed successfully via surgery and adequate post-operative care without any complications. Clinical discussion Duplications are more frequently single. They are usually located in the mesenteric border of the associated native bowel and may vary in shape and size. Most of them are cystic, followed by tubular and mixed type, with or without other congenital anomalies. More than 80% of the cases present before the age of 2 years as an acute abdomen or bowel obstruction, but many duplications remain silent unless complications occur, and therefore may not be diagnosed until adulthood. Complications of enteric DC include volvulus, bleeding, and, rarely, malignant degeneration. Conclusion It is important for paediatric surgeons to include DC in the differential diagnosis if a neonate presents with features of intestinal obstruction.
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Affiliation(s)
| | | | - Sagar Pokhrel
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Sunsari
| | - Tek Nath Yogi
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Sunsari
| | - Sujal Labh
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Sunsari
| | - Kshitiz Acharya
- Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
| | - Sushan Pokharel
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Sunsari
| | - Madhur Bhattarai
- Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
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18
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Yuan Z, Wei H, Zhang Y, Cao B, He B, Yuan H. Gastric duplication cysts: literature review and a case report of rare multiple gastric duplication cysts treated by endoscopic submucosal dissection. Postgrad Med 2023; 135:775-783. [PMID: 37877305 DOI: 10.1080/00325481.2023.2274308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/18/2023] [Indexed: 10/26/2023]
Abstract
Gastric duplication cysts (GDCs) are rare structural abnormalities, especially in adults. We first report a rare case of small multiple GDCs in a woman, which presents as a submucosal tumor (SMT) at the gastric antrum. In consideration of the patient's request for surgical treatment and minimally invasive resection, endoscopic submucosal dissection (ESD) was performed to remove the cyst. The case provides a reference for ESD surgery to remove small GDCs. So far, there is no consensus or practice guidelines for the diagnosis and management of GDCs. Herein we perform a comprehensive literature review and discussion on GDCs. GDCs are 'repetitive' cystic or tubular structures of gastric mucosa and muscularis mucosae, and share the muscularis propria and serous layer with the normal gastric wall. GDCs protruding into the stomach cavity can be diagnosed by endoscopic ultrasound (EUS), which has higher specificity and accuracy than CT and MRI. Some GDCs may cause complications, even cancerization. Therefore, we suggest that once found, the GDCs could be completely resected. For GDCs protruding into the stomach cavity, endoscopic surgery such as ESD can be adopted to remove the lesion. Endoscopic full-thickness resection (EFTR) may become an option for larger GDCs in the future. For extraluminal GDC, laparoscopic surgery is currently preferred. In this review, we summarized the structural and histopathological characteristics of GDCs and various treatment therapies, in order to provide experience and reference for the diagnosis and treatment of GDCs in the future.
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Affiliation(s)
- Ziying Yuan
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hongyun Wei
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yuejuan Zhang
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Bin Cao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Baoguo He
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hao Yuan
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Shibata J, Tomida A, Hattori M, Hirata A, Imataki H, Orihara Y, Shintomi H, Aono K, Yoshihara M. Duplication of the appendix masquerading as appendiceal tumor: a case report. Surg Case Rep 2023; 9:190. [PMID: 37902889 PMCID: PMC10615990 DOI: 10.1186/s40792-023-01769-7] [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: 10/01/2023] [Accepted: 10/17/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND This case report highlights the exceptional rarity of appendix duplication in adults, a condition that closely mimics appendiceal tumors, posing diagnostic challenges. The novelty of this case lies in its presentation of a Type A duplication, emphasizing the diagnostic intricacies involved in distinguishing it from other pathologies. CASE PRESENTATION We present the case of a 69-year-old male with a history of hypertension, hyperuricemia, and duodenal gastric ulcer, who presented with a positive occult blood test. Lower gastrointestinal endoscopy revealed an appendiceal orifice with atypical hyperemia and edema. Subsequent imaging and biopsy results suggested an appendiceal tumor, prompting laparoscopic ileocecal resection. Intraoperative findings revealed an unremarkable appendix, but histopathological analysis unveiled appendiceal duplication, characterized by bifurcation into two lumens within a thick serosal wall. The patient was discharged without complications. CONCLUSIONS This case underscores the importance of recognizing appendix duplication as a rare differential diagnosis for appendiceal tumors. Surgeons should remain vigilant, especially in cases of Type A duplication, where preoperative diagnosis remains challenging. Early identification can avert potential complications and missed congenital anomalies.
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Affiliation(s)
- Jumpei Shibata
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan.
| | - Akihiro Tomida
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan
| | - Masaoki Hattori
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan
| | - Akihiro Hirata
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan
| | - Hiromitsu Imataki
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan
| | - Yukiya Orihara
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan
| | - Hideharu Shintomi
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan
| | - Keiya Aono
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan
| | - Motoi Yoshihara
- Department of Surgery, Nishichita General Hospital, 3-1-1 Nakanoike, Tokai, Aichi, 477-8522, Japan
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20
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Kanbar M, Alomar K, Alkader MA, Alloun M, Al Dalati H, Alghazal LK. A unique case of complete tubular colonic duplication with normal anus accompanied by vestibular fistula in a 12 years _ old _ girl - A case report. Int J Surg Case Rep 2023; 108:108405. [PMID: 37352770 PMCID: PMC10382748 DOI: 10.1016/j.ijscr.2023.108405] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 06/25/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Duplication of the digestive system is one of the rare cases, which can vary in shape and size and is cystic in 80 % of cases. Most cases of duplication are often diagnosed before the age of two years. There are many ways to make the diagnosis, with computed tomography being the best, and duplication is often diagnosed during surgery. CASE PRESENTATION We present the case of a child suffering from complete duplication of colon with normal anus, accompanied by vestibular fistula with double urethra and vagina. The diagnosis was made at our hospital, the necessary surgery was performed, and a future plan for the child's condition was developed. CLINICAL DISCUSSION: a colonic duplication may be associated with malformations of other organs, and sometimes it may be associated with a vestibular or vaginal fistula. Therefore, we must evaluate patients for other anomalies when diagnosing a duplication. The most appropriate diagnostic method is CT, and surgery is recommended in symptomatic or asymptomatic patients. CONCLUSION When keeping in mind the possibility of a duplication of the digestive system, the surgeon helps to plan the surgery well, in addition to the importance of informing the parents of the possibility of eradication.
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Affiliation(s)
| | - Khaled Alomar
- Damascus University, University pediatrics' Hospital, Syria.
| | | | - Maher Alloun
- Damascus University, University pediatrics' Hospital, Syria
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21
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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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22
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Alomar K, Mansour H, Qatleesh S, Eid N, Alkader MA, Al Dalati H. Diagnosis and surgical management of a rare case of duodenal duplication cyst in a neonate: Case report and literature review. Int J Surg Case Rep 2023; 107:108354. [PMID: 37267789 DOI: 10.1016/j.ijscr.2023.108354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Duodenal duplication cysts are a rare subtype of alimentary tract duplications cysts, consisting of 7 % of all the duplications. The clinical presentation is variable, depending on the size, location and mass effect. Most duodenal duplication cysts abut the second or third portion of the native duodenum. The standard treatment of choice for symptomatic enteric duplication cysts is complete surgical removal. In our case, by examining the abdomen, ectopic pancreatic tissue was found on the wall of the transverse colon, along with Meckel's diverticulum, 50 cm from the ileocecal junction. CASE PRESENTATION We present a newborn case presented to the hospital with a history of abdominal mass with jaundice. Abdominal ultrasonography and CT scan show the presence of a cystic mass without specifying its exact source. By opening the abdomen, it was found at the expense of the duodenum, and it was excised and On histopathological analysis, a duodenal duplication cyst was diagnosed. The literature was reviewed and the approach to duodenal duplication cyst in neonates is discussed. CLINICAL DISCUSSION Duodenal duplication cysts are rare, even so should be taken into consideration when a mass is found. A thorough imaging investigation is crucial in establishing the diagnosis along with histopathology. CONCLUSION When diagnosing a Duodenal duplication cysts, the cyst must be completely removed because potential risk of malignant transformation.
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Affiliation(s)
- Khaled Alomar
- Damascus University, University Pediatrics' Hospital, Syrian Arab Republic.
| | - Hasan Mansour
- Damascus University, University Pediatrics' Hospital, Syrian Arab Republic
| | - Safaa Qatleesh
- Damascus University, Al Assad University Hospital, Syrian Arab Republic
| | - Nader Eid
- Damascus University, University Pediatrics' Hospital, Syrian Arab Republic
| | | | - Husam Al Dalati
- Damascus University, University Pediatrics' Hospital, Syrian Arab Republic
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23
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Miry N, Karich N, Bakhti M, Deflaoui T, Bennani A. Unusual Presentation of an Ileal Duplication Cyst: A Case Report. Cureus 2023; 15:e38959. [PMID: 37313060 PMCID: PMC10258869 DOI: 10.7759/cureus.38959] [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: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
Duplication cyst (DC) of the digestive tract is a rare embryological anomaly, presenting as a cystic formation that could be attached to any part of the digestive tract, it is a thin-walled structure made of two layers, an inner layer that is frequently lined by an alimentary epithelium, surrounded by a smooth muscle layer often shared with the adjacent digestive segment. DCs are most commonly located in the distal ileum; sometimes, they are associated with other visceral or skeletal anomalies. They are frequently discovered during childhood, following a bowel obstruction or abdominal pain. Here we report a rare case of an ileal DC lined by a pseudostratified and ciliated epithelium, discovered in an adult patient following intestinal obstruction syndrome.
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Affiliation(s)
- Nadir Miry
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Nassira Karich
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Mohammed Bakhti
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Tarik Deflaoui
- Department of Visceral Surgery and Digestive Oncology, Mohammed VI University Hospital, Oujda, MAR
| | - Amal Bennani
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
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24
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Shchapov N, Kulikov D, Ekimovskaya E, Sergeyeva S, Andreyeva E, Ivanitskaya O. Laparoscopic cyst enucleation is a promising technique for treatment of gastrointestinal tract duplications in children. J Pediatr Surg 2023; 58:658-663. [PMID: 36641312 DOI: 10.1016/j.jpedsurg.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/12/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Laparoscopic cyst enucleation has its advantages and limitations in treatment of gastrointestinal tract (GIT) duplications. It allows to avoid bowel resection in such locations as ileocecal valve. We introduced laparoscopic cyst enucleation with further bowel plasty using cyst muscle layer and without monopolar coagulation, for cyst dissection we used straight scissors. MATERIALS AND METHODS Our study included 20 children with GIT duplications, who underwent cyst enucleation from 2018 to 2021. Laparoscopy was performed in all cases with various cyst locations (stomach - 2, duodenum - 3, small bowel - 14, ileocecal area - 1). Mean age of surgery was 40 ± 35,3 days (min 6 days, max 150 days). RESULTS Mean operation time was 84,4 ± 27,35 min (min - 40 min, max - 160 min). We had no intraoperative complications. All patients received parenteral feeding for 3-5 days after the operation. Postoperative complications occurred in 3 cases: bowel perforation which required enterostomy (10%) and bowel volvulus required resection (5%). To our opinion, perforations occurred due to monopolar coagulation used for cyst enucleation in these children. No complications were observed in patients who underwent enucleation by straight scissors. Mean postoperative hospital stay was 15.6 ± 10.48 days (min - 4 days, max - 58 days). We observed neither stenosis nor any other complications in the long-term follow-up. CONCLUSIONS Laparoscopic cyst enucleation is a feasible and safe approach for GIT duplications. It allows to avoid bowel resection, and the use of straight scissors instead of monopolar coagulation provides less postoperative complications such as perforation. THE LEVEL OF EVIDENCE III.
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Affiliation(s)
- Nikolay Shchapov
- Thoracoabdominal Surgery Service and Emergency Surgical Care for Children, Ilyinskaya Hospital, Build. 2, 2, Rublevskoe Predmestie St., Vil. Glukhovo, Moscow Region, 143421, Russia; Department of Neonatal Surgery, Moscow Regional Center for Maternity and Childhood Healthcare, 338A, Oktyabrskiy Prosp., Lybertsy, Moscow Region, 140014, Russia.
| | - Denis Kulikov
- Thoracoabdominal Surgery Service and Emergency Surgical Care for Children, Ilyinskaya Hospital, Build. 2, 2, Rublevskoe Predmestie St., Vil. Glukhovo, Moscow Region, 143421, Russia
| | - Ekaterina Ekimovskaya
- Surgical Department of Newborns and Infants, The National Medical Research Center of Children's Health, 2/1, Lomonosovskiy Prosp., Moscow, 119991, Russia; Department of Neonatal Surgery, Moscow Regional Center for Maternity and Childhood Healthcare, 338A, Oktyabrskiy Prosp., Lybertsy, Moscow Region, 140014, Russia
| | - Svetlana Sergeyeva
- Department of Neonatal Surgery, Moscow Regional Center for Maternity and Childhood Healthcare, 338A, Oktyabrskiy Prosp., Lybertsy, Moscow Region, 140014, Russia
| | - Elena Andreyeva
- Medical Genetics Department, Moscow Regional Research Institute of Obstetrics and Gynecology, 22A, Pokrovka St., Moscow, 101000, Russia; Department of Prenatal Diagnostics, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Build. 1, 2/1, Barrikadnaya St., Moscow, 125993, Russia
| | - Olga Ivanitskaya
- Medical Genetics Department, Moscow Regional Research Institute of Obstetrics and Gynecology, 22A, Pokrovka St., Moscow, 101000, Russia
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25
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Deguchi K, Saka R, Watanabe M, Masahata K, Nomura M, Kamiyama M, Ueno T, Tazuke Y, Okuyama H. Ileocecal valve-sparing surgery for duplication cysts in the terminal ileum: two case reports and literature review. Surg Case Rep 2022; 8:130. [PMID: 35792950 PMCID: PMC9259777 DOI: 10.1186/s40792-022-01483-w] [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] [Received: 04/18/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022] Open
Abstract
Background Duplication cysts close to the ileocecal valve are usually treated with ileocecal resection. However, loss of the ileocecal valve will lead to problems, especially in infants. Mucosectomy of the cyst would be a better alternative that preserves the ileocecal valve. We report two cases of duplication cyst in the terminal ileum successfully treated with mucosectomy. Case presentation Case 1. A 3-month-old boy with bilious emesis and abdominal distention was referred to our hospital with a diagnosis of small bowel obstruction caused by an abdominal cyst. Computed tomography revealed a cystic mass compressing the terminal ileum and causing mechanical small bowel obstruction. His general condition deteriorated quickly; emergency laparotomy was performed. Although the small intestines were dilated and partially twisted, there was no necrosis. Following intestinal decompression, a cystic mass adjacent to the terminal ileum was confirmed on the mesenteric side. Cyst mucosectomy was performed to preserve the ileocecal valve. Case 2. A 5-month-old boy with sudden onset of hematochezia was referred to our hospital with a diagnosis of intussusception. Following unsuccessful contrast enemas, emergency surgery was performed. A cystic mass adjacent to the terminal ileum was confirmed; there was no intussusception. Cyst mucosectomy was performed. Both patients had an uneventful postoperative course. Conclusions Cyst mucosectomy, which preserves the ileocecal valve, is safe and effective for treating duplication cysts in the terminal ileum.
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Ye X, Wang M, Wang Y, Lin D, Wang X. Gastric duplication cyst with ectopic pancreas in a teenager successfully resected by endoscopic submucosal dissection. BMC Surg 2022; 22:381. [PMID: 36336689 PMCID: PMC9639261 DOI: 10.1186/s12893-022-01837-z] [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: 01/15/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Gastric duplication cyst associated with ectopic pancreas is rare and we aimed to alert clinician to this congenital anomaly. CASE PRESENTATION A 15-year-old girl presented with intermittent vomiting. Gastroscopy showed a submucosal tumor with an approximate diameter of 40 mm in the anterior wall of the gastric antrum. The lesion had a central umbilication and was diagnosed preliminarily as gastric ectopic pancreas with pseudocyst formation on the basis of its appearance. However, computed tomographic scan showed a thick-walled cystic lesion with an enhanced outline of the cystic wall in the antrum of stomach, suggestive of duplication cyst. Serum amylase was normal. Endoscopic ultrasonography revealed a solid-cystic lesion; the solid portion were inhomogeneously mixed with echoes, and had indistinct border to muscularis propria; the cystic portion had echogenic internal mucosal layer and distinct border to muscularis propria. Endoscopic submucosal dissection (ESD) was suggested for the patient to relieve symptoms and diagnose the lesion definitely. The operation procedure was uneventful and the solid-cystic lesion was resected completely. Histopathologic examination revealed that the solid portion was ectopic pancreas, and the cystic portion was gastric duplication cyst. After resection, the patient discharged successfully and neither symptoms nor tumors recurred during the 9 months follow-up period. CONCLUSIONS This is the first case of a solid-cystic lesion with central umbilication in the stomach diagnosed as gastric duplication cyst associated with ectopic pancreas. ESD could be an optional treatment to provide a definitive diagnosis.
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Affiliation(s)
- Xiaodan Ye
- grid.452734.3Department of Endoscopy Center, Shantou Central Hospital, 114 Waima Road, Shantou, 515041 Guangdong China
| | - Muqing Wang
- grid.452734.3Department of Endoscopy Center, Shantou Central Hospital, 114 Waima Road, Shantou, 515041 Guangdong China
| | - Yuanyuan Wang
- grid.452734.3Department of Pathology, Shantou Central Hospital, Shantou, China
| | - Daiying Lin
- grid.452734.3Department of Imaging, Shantou Central Hospital, Shantou, China
| | - Xiaozhong Wang
- grid.452734.3Department of Endoscopy Center, Shantou Central Hospital, 114 Waima Road, Shantou, 515041 Guangdong China
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Cai X, Bi JT, Zheng ZX, Liu YQ. Complete colonic duplication presenting as hip fistula in an adult with pelvic malformation: A case report. World J Clin Cases 2022; 10:11037-11043. [PMID: 36338216 PMCID: PMC9631126 DOI: 10.12998/wjcc.v10.i30.11037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/07/2022] [Accepted: 09/06/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Alimentary tract duplication (ATD) is a rare congenital anomaly. Thus, a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very distinctive. These characteristics show the variability of this disease and explain why it tends to be challenging to diagnose and treat.
CASE SUMMARY A 25-year-old woman with a history of a fistula opening in her right hip since birth presented with the irregular discharge of foul fluid from the fistula and intermittent abdominal pain. Contrast-enhanced computed tomography and magnetic resonance imaging findings revealed a duplicated tube isolated in her abdominal pelvic cavity along with a pelvic malformation and double ureter. Right foot radiographic examination showed pes cavus. During surgery, the tube appeared to be an almost complete colonic structure and was verified to be connected to the fistula. All of the involved tissue and fistula were removed, and the defect in the pelvic floor was closed by suturing after surgery. After 8 mo, the postoperative follow-up has been uneventful.
CONCLUSION ATD may be a differential diagnosis in sinus tract cases. Laparoscopy combined with open surgery is a viable treatment option.
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Affiliation(s)
- Xuan Cai
- Department of General Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Jing-Tao Bi
- Department of General Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Zhi-Xue Zheng
- Department of General Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Ya-Qi Liu
- Department of General Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
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Baranski T, Piroth W, Seiffert P, William M, Tröbs RB. Stridor caused by duplication cyst in a female infant and temporary vocal cord paralysis. A case report. Int J Surg Case Rep 2022; 98:107557. [PMID: 36055173 PMCID: PMC9482990 DOI: 10.1016/j.ijscr.2022.107557] [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] [Received: 04/28/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction and importance Congenital hypopharynx duplication cysts are a medical rarity; nevertheless, they offer an important differential diagnosis in neonatal dyspnea or feeding problems. Case report Herein, we describe a case of delayed diagnosis but successful surgical removal of a large congenital hypopharynx cyst in a 4-month-old infant presenting with stridor. Clinical discussion Early and proper diagnosis and surgical handling of hypopharynx cyst can help to achieve the best prognosis and outcome. Conclusion We present the successful management of a newborn with a pharyngeal duplication cyst. In our case, the temporary postoperative laryngeal nerve palsy resolved within four weeks. Overstretching of recurrent laryngeal nerve might have caused this complication.
Surgical differential diagnoses of inspiratory and expiratory stridor in infants Therapeutic options to avoid relapse after surgery for neck duplication cysts Vocal cord paralysis caused by stretching may resolve Histological findings support the origin in the time of foregut separation
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Pușcașu CI, Rimbaş M, Mateescu RB, Larghi A, Cauni V. Advances in the Diagnosis of Pancreatic Cystic Lesions. Diagnostics (Basel) 2022; 12:diagnostics12081779. [PMID: 35892490 PMCID: PMC9394320 DOI: 10.3390/diagnostics12081779] [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] [Received: 06/25/2022] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
Pancreatic cystic lesions (PCLs) are a heterogenous group of lesions ranging from benign to malignant. There has been an increase in PCLs prevalence in recent years, mostly due to advances in imaging techniques, increased awareness of their existence and population aging. Reliable discrimination between neoplastic and non-neoplastic cystic lesions is paramount to ensuring adequate treatment and follow-up. Although conventional diagnostic techniques such as ultrasound (US), magnetic resonance imaging (MRI) and computer tomography (CT) can easily identify these lesions, assessing the risk of malignancy is limited. Endoscopic ultrasound (EUS) is superior to cross-sectional imaging in identifying potentially malignant lesions due to its high resolution and better imaging characteristics, and the advantage of allowing for cyst fluid sampling via fine-needle aspiration (FNA). More complex testing, such as cytological and histopathological analysis and biochemical and molecular testing of the aspirated fluid, can ensure an accurate diagnosis.
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Affiliation(s)
- Claudia Irina Pușcașu
- Gastroenterology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania; (C.I.P.); (R.B.M.)
| | - Mihai Rimbaş
- Gastroenterology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania; (C.I.P.); (R.B.M.)
- Department of Internal Medicine, Carol Davila University of Medicine, 050474 Bucharest, Romania
- Correspondence: ; Tel.: +40-723-232-052
| | - Radu Bogdan Mateescu
- Gastroenterology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania; (C.I.P.); (R.B.M.)
- Department of Internal Medicine, Carol Davila University of Medicine, 050474 Bucharest, Romania
| | - Alberto Larghi
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Victor Cauni
- Urology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania;
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Dajenah M, Ahmed F, Almohtadi A, Thabet A, Ghaleb K, Al-Yousofy F, Mohammed F. Cecal duplication cyst presenting with acute abdomen: a case report. Pan Afr Med J 2022; 41:280. [PMID: 35784599 PMCID: PMC9206177 DOI: 10.11604/pamj.2022.41.280.33731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/01/2022] [Indexed: 11/11/2022] Open
Abstract
Cecal duplication cyst is a rare congenital malformation with a few reported adult cases. We present a 23-year-old man who presented with low-grade fever, constipation, and right lower quadrant pain for three days. An abdominal computed tomography scan showed a cystic mass of 8.8x7.5x6 cm adjoining to the posterior wall of the cecum. The patient underwent abdominal laparotomy, and a right hemicolectomy was performed with resection of the duplication cyst. The histopathological study confirmed the diagnosis of a non-communicating cecal duplication cyst. In conclusion, it is essential to include cecal duplication cyst in the differential diagnosis of the acute abdomen to guarantee the best treatment strategy.
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Affiliation(s)
- Menawar Dajenah
- Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Faisal Ahmed
- Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Abdullatif Almohtadi
- Department of Radiology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Anessa Thabet
- Department of Gynecology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Khaled Ghaleb
- Department of Internal Medicine, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Fayed Al-Yousofy
- Department of Pathology, Faculty of Medicine, Taiz University of Medical Science, Taiz, Yemen
| | - Fawaz Mohammed
- Department of Orthopedy, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
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Harputluoğlu N, Çelik T, Temir G, Hoşgör M. Thoraco-abdominal duplication cyst of the jejunum presenting as respiratory distress in a young infant—a case report. Oxf Med Case Reports 2022; 2022:omac070. [PMID: 35903620 PMCID: PMC9318883 DOI: 10.1093/omcr/omac070] [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: 01/20/2022] [Revised: 05/22/2022] [Accepted: 05/29/2022] [Indexed: 11/12/2022] Open
Abstract
Thoraco-abdominal duplication cysts are rare congenital anomalies that can accompany vertebral and spinal cord pathologies and occur most frequently in the small intestines. Symptoms such as respiratory distress, dyspnea, tachypnea, cough, hemoptysis, cyanosis, vomiting and dysphagia may develop depending on the location. The cyst has several clinical and radiological dilemmas. We present a rare case of thoraco-abdominal duplication cyst in a 3-month-old male patient presenting with respiratory distress in the neonatal period. Thoraco-abdominal duplications require a high index of suspicion and meticulous clinical management. Thus, patients can be successfully managed without any unnecessary interventions, complications and loss of time.
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Affiliation(s)
- Nilgün Harputluoğlu
- Izmir Dr Behçet Uz Children's Hospital , Pediatric Palliative Care Center-Izmir, Turkey
| | - Tanju Çelik
- Izmir Dr Behçet Uz Children's Hospital , Pediatric Palliative Care Center-Izmir, Turkey
| | - Günyüz Temir
- Izmir Dr Behçet Uz Children's Hospital , Department of Pediatric Surgery-Izmir, Turkey
| | - Münevver Hoşgör
- Izmir Dr Behçet Uz Children's Hospital , Department of Pediatric Surgery-Izmir, Turkey
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Usefulness of Contrast-Enhanced CT in a Patient with Acute Phlegmonous Esophagitis: A Case Report and Literature Review. Medicina (B Aires) 2022; 58:medicina58070864. [PMID: 35888583 PMCID: PMC9320998 DOI: 10.3390/medicina58070864] [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] [Received: 06/03/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Acute phlegmonous esophagitis is a very rare, life-threatening form of esophagitis, characterized by diffuse bacterial infection and pus formation within the submucosal and muscularis layers of the esophagus. We describe a case in which contrast-enhanced chest CT was useful for evaluating the severity of phlegmonous esophagitis, which was overlooked and underestimated by endoscopy.
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Piplani R, Acharya SK, Bagga D. Recto-vestibular fistula with colonic duplication: report of three cases and review of literature. ANNALS OF PEDIATRIC SURGERY 2022. [DOI: 10.1186/s43159-022-00186-z] [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
Anorectal malformations associated with colonic duplications are a rare condition. Double terminations of tubular colonic duplication in the perineum are even rarer. Colonic duplication may have different presentations according to its location and size and incidence of less than 15% of all gastrointestinal duplications. We hereby report three such cases of recto-vestibular fistula along with underlying tubular colorectal duplication over a period of 10 years (2010–2020) managed successfully by different surgical approaches. These cases also illustrate the diagnostic challenge and variable presentation of colonic duplications in female patients with recto-vestibular fistula.
Case presentation
Case 1 is a patient with flank heteropagus with absent anal opening and recto-vestibular fistula, while cases 2 and 3 presented as suspected H-type recto-vestibular fistula with normal anal opening. All the cases were however managed with a specific surgical approach on case basis. Duplicated colon was excised in case 1, but in case 2 and case 3, duplicated colon was converted into single channel using proximal and distal staplers. Further definitive repair of female recto-vestibular fistula was done.
Conclusions
Colorectal duplication is a rare congenital malformation, and their association with anorectal malformations is even rarer. This association can have varied presentation, and surgical approach should be according to the congenital anatomical variations on case-to-case basis. Colonic duplications should always be ruled out in a female newborn child with history of passage of stools both from the vestibule and anus.
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CAGLAR OSKAYLI M, ERSOY F, GULCIN N, PIRIM A, OZEL SK, OZKANLI S, ULUKAYA DURAKBASA C. Gastrointestinal Tract Duplications in Children: A Tertiary Referral Center Experience. Medeni Med J 2022; 37:138-144. [PMID: 35734973 PMCID: PMC9234364 DOI: 10.4274/mmj.galenos.2022.46383] [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] [Indexed: 12/01/2022] Open
Abstract
Objective: Methods: Results: Conclusions:
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35
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Kurita S, Kitagawa K, Toya N, Kawamura M, Kawamura M, Eto K. Endoscopic resection of a duodenal duplication cyst: A case report. DEN OPEN 2022; 2:e88. [PMID: 35310702 PMCID: PMC8828194 DOI: 10.1002/deo2.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/19/2021] [Accepted: 12/11/2021] [Indexed: 11/11/2022]
Abstract
A duodenal duplication cyst (DDC) is a rare congenital anomaly. Gastrointestinal duplication cysts are traditionally treated by complete surgical resection due to the potential precancerous conditions. Here, we describe an asymptomatic DDC that was successfully treated using endoscopic resection. A submucosal tumor in the descending portion of the duodenum was detected in a 71‐year‐old female during a regular checkup at our hospital. Upper gastrointestinal endoscopy showed a 10‐mm pedunculated submucosal tumor. Endoscopic ultrasonography revealed a 10‐mm cystic tumor of low echogenicity that included nodules and debris. Endoscopic resection with hot snare polypectomy was performed for diagnosis and treatment. The postoperative course was uneventful. Histologic examination revealed that the cystic tumor was a DDC. Endoscopic resection is a safe, effective, and minimally invasive alternative to surgical resection for small DDCs with malignant potential.
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Affiliation(s)
- Sayumi Kurita
- Department of Surgery The Jikei University Kashiwa Hospital Chiba Japan
| | - Kazuo Kitagawa
- Department of Surgery The Jikei University Kashiwa Hospital Chiba Japan
| | - Naoki Toya
- Department of Surgery The Jikei University Kashiwa Hospital Chiba Japan
| | | | | | - Ken Eto
- Department of Surgery The Jikei University School of Medicine Tokyo Japan
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Matsukubo M, Muto M, Kedoin C, Matsui M, Murakami M, Sugita K, Yano K, Onishi S, Harumatsu T, Yamada K, Yamada W, Kaji T, Ieiri S. An unusual presentation of intestinal duplication mimicking torsion of Meckel's diverticulum: a rare report of a pediatric case. Surg Case Rep 2022; 8:53. [PMID: 35344094 PMCID: PMC8960505 DOI: 10.1186/s40792-022-01409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Enteric duplication is a congenital disease that occurs throughout the entire gastrointestinal tract. Although it may sometimes cause intestinal volvulus, a few reports have described cases of enteric duplication twisted on itself. We experienced a rare pediatric case of long-segment tubular ileal duplication showing torsion. Torsion of enteric duplication is extremely rare. We herein report a pediatric case showing unusual torsion of ileal duplication requiring emergency surgery. Case presentation A 3-year-old boy presented with abdominal pain and vomiting. Contrast-enhanced computed tomography (CT) revealed a cystic luminal structure with a blind end and fluid collection in the pelvic cavity. CT also showed no findings of ileus or intestinal dilatation except for a cystic luminal structure. The preoperative diagnosis was torsion of Meckel’s diverticulum. The patient underwent emergent explorative diagnostic laparoscopy. As a result, a necrotic luminal structure and bloody ascites were recognized, and small-scale laparotomy was performed. Long-segment ileal duplication was recognized. The long-segment tubular ileal duplication shared the anti-mesenteric side of the intestinal wall along one-third of its length. The residual two-thirds of its length was free from the ileum and its blind end was twisted in a manner that looked similar to Meckel’s diverticulum. Normal ileum and the duplication, including the twisted necrotic portion, were resected, and ileal anastomosis was performed. The postoperative course was uneventful. A pathological examination confirmed the definitive diagnosis of enteric duplication. Conclusions We reported the unusual presentation of intestinal duplication mimicking torsion of Meckel’s diverticulum. Enteric duplication shows various clinical symptoms and presentations. We must understand that the classification of digestive enteric duplication is diverse with a variety of associated clinical symptoms.
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Affiliation(s)
- Makoto Matsukubo
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Mitsuru Muto
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Chihiro Kedoin
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Mayu Matsui
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Masakazu Murakami
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Koshiro Sugita
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Keisuke Yano
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Shun Onishi
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Toshio Harumatsu
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Koji Yamada
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Waka Yamada
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan.,Clinical Training Center, Kagoshima University Hospital, Kagoshima, Japan
| | - Tatsuru Kaji
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Satoshi Ieiri
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan.
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Cavadas S, Gonçalves E, Costa-Pereira C, Costa-Pereira J. Rectal duplication cyst in an adult with a history of imperforate anus: a diagnostic challenge. BMJ Case Rep 2022; 15:e248791. [PMID: 35292550 PMCID: PMC8928239 DOI: 10.1136/bcr-2022-248791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/04/2022] Open
Abstract
Rectal duplications are rare congenital anomalies that represent 1%-6% of alimentary tract duplications. We report a case of a woman in her 50s who presented to our hospital with perianal pain and urinary retention. She had a history of imperforate anus repaired after birth and dynamic graciloplasty performed during her adulthood for faecal incontinence. Abdominal CT scan showed a fluid collection extending from the electrostimulator, placed in a subcutaneous pocket in the abdomen, to the rectouterine pouch. Infection related to the electrostimulator was assumed and, after a course of antibiotics without patient improvement, the electrostimulator was removed. The symptoms and the pelvic fluid collection persisted, and diagnostic laparoscopy was performed. Diagnosis of rectal duplication cyst was made intraoperatively, and the cyst was completely resected. Patient fully recovered after surgery. This is a rare case of a rectal duplication cyst presenting during adulthood and associated with imperforate anus.
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38
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Laabidi S, Ben Mohamed A, Khsiba A, Yakoubi M, Mahmoudi M, Medhioub M, Hamzaoui L, Azouz MM. Acquired double pylorus presenting as a gastrointestinal bleeding. Clin Case Rep 2022; 10:e05634. [PMID: 35340641 PMCID: PMC8935129 DOI: 10.1002/ccr3.5634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/14/2022] [Accepted: 03/07/2022] [Indexed: 11/07/2022] Open
Abstract
We present the case of a 65-year-old man without a past medical history who was admitted for gastrointestinal bleeding. The case shows an acquired double pylorus due to probable pre pyloric ulcer.
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Affiliation(s)
- Sarra Laabidi
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Asma Ben Mohamed
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Amal Khsiba
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Manel Yakoubi
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Moufida Mahmoudi
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Mouna Medhioub
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Lamine Hamzaoui
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
| | - Mohamed Mssadak Azouz
- Gastroenterology Department Hospital Mohamed Taher Maamouri Nabeul Tunisia
- Faculty of Medicine of Tunis University of Tunis el Manar Tunis Tunisia
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Case report of the duplex vermiform appendix: A rare presentation in an elderly patient. Int J Surg Case Rep 2022; 92:106829. [PMID: 35217427 PMCID: PMC8881364 DOI: 10.1016/j.ijscr.2022.106829] [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] [Received: 01/16/2022] [Revised: 02/05/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction and importance Duplex appendix is a rare anatomical entity with incidence rate of 0.004 and 0.009%. Diagnosis is often missed despite growth in radiological investigations. Missed appendiceal anomalies can lead to undesirable medicolegal implications. Case presentation Here we discuss a case of a 76-year-old-male who initially presented to his primary care physician with right-sided abdominal pain for several weeks. A colonoscopy was performed and demonstrated a lesion arising from the appendicular orifice. The patient underwent staging imaging including Computerised Tomography of the abdomen and pelvis which demonstrated a dilated appendix. The patient underwent a laparoscopic right hemicolectomy. He made an uneventful recovery post-operatively and at his follow-up review at 4 weeks and 2 months. Discussion While duplex appendix has been reported in the literature, to our knowledge this is the first case report to describe duplicated appendix presenting as a colonic mass in an elderly patient. Conclusion Intra-operative examination of the cecum is paramount to rule out appendiceal anomalies and prevent medicolegal complications.
Duplex appendix is a rare entity with incidence rate of 0.004–0.009%. Diagnosis of duplicated appendix is often missed despite growth in radiological investigation. Missed appendiceal anomalies can lead to undesirable medicolegal implications. Intra-operative examination is the only reliable option to rule out appendiceal anomalies.
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Prenatal diagnosis of gastric duplication cyst at the fundus. Pediatr Neonatol 2022; 63:89-90. [PMID: 34565696 DOI: 10.1016/j.pedneo.2021.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/15/2021] [Accepted: 07/23/2021] [Indexed: 12/11/2022] Open
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Chen J, Xiong GZ, Tan X, Wu F, Luo DY, Zou QQ, Deng Z, Bi GS. Intraluminal Diverticular Duodenal Duplication With Recurrent Abdominal Pain: A Case Report. Front Pediatr 2022; 10:833304. [PMID: 35372145 PMCID: PMC8965004 DOI: 10.3389/fped.2022.833304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Duodenal duplication is a rare congenital anomaly and may manifest as pancreatitis, gastrointestinal bleeding, abdominal pain, perforation, and obstruction. Here, we present a case of intraluminal diverticular duodenal duplication (IDDD) in a child with recurrent abdominal pain caused by a large hole-like structure in the duodenal bulb. This condition has rarely been reported. An 11-year-old boy presented with recurrent attacks of abdominal pain. Upper endoscopy examination and barium swallowing led to an initial diagnosis of IDDD; this diagnosis was confirmed by operative findings and histopathological signs. He underwent a subtotal excision and duodenal anastomosis. No serious complications occurred following treatment. The patient was followed up for 8 months, and his condition improved without symptoms.
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Affiliation(s)
- Jie Chen
- Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Guo-Zuo Xiong
- Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Xiong Tan
- Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Fei Wu
- School of Nursing, University of South China, Hengyang, China
| | - Dong-Yang Luo
- Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Qing-Qing Zou
- Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Zhihe Deng
- Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Guo-Shan Bi
- Department of Vascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
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An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time. Surg Case Rep 2021; 7:258. [PMID: 34914020 PMCID: PMC8677869 DOI: 10.1186/s40792-021-01337-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Adult cases of retroperitoneal isolated enteric duplication cyst (IEDC) are rare, with only 17 case reports in the relevant literature. We herein present a case, which was characterized by changes in intra-cystic density on computed tomography (CT), which was safely resected by laparoscopic surgery. Case presentation The patient was a 60-year-old male who received abdominal CT to investigate the cause of increased serum CA19-9 levels. CT revealed a unilocular cystic mass located in the lower right retroperitoneum. The size increased from 5 to 10 cm in three and a half years and the CT value decreased from 101 Hounsfield Units (HU) to 20 HU. We performed laparoscopic surgical resection, because the possibility that the enlargement of the lesion represented malignant transformation could not be denied. The large cystic mass firmly adhered to the appendix and its mesentery via the retroperitoneum, the appendix was resected en bloc with the cystic lesion. Microscopically, it had no communication with the appendix, and had an intestinal wall structure of muscularis mucosae and muscularis propria. The final pathological diagnosis was IEDC in the retroperitoneal space. There was no histological evidence of malignancy. Conclusion When we encounter a retroperitoneal cystic lesion, we should consider the possibility of malignancy to determine the treatment strategy and perform a careful operation without breaking the cyst wall, irrespective of the preoperative diagnosis.
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Neonatal enteric duplication cyst with segmental gut volvulus. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.102105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kim HHR, Hull NC, Lee EY, Phillips GS. Pediatric Abdominal Masses: Imaging Guidelines and Recommendations. Radiol Clin North Am 2021; 60:113-129. [PMID: 34836559 DOI: 10.1016/j.rcl.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pediatric abdominal masses are commonly encountered in the pediatric population, with a broad differential diagnosis that encompasses benign and malignant entities. The primary role of abdominal imaging in the setting of a suspected pediatric abdominal mass is to establish its presence, as nonneoplastic entities can mimic an abdominal mass, and to identify characteristic imaging features that narrow the differential diagnosis. In the setting of a neoplasm, various imaging modalities play an important role to characterize the mass, stage extent of disease, and assist in presurgical planning. The purpose of this article is to discuss a practical imaging algorithm for suspected pediatric abdominal masses and to describe typical radiological findings of the commonly encountered abdominal masses in neonates and children with emphasis on imaging guidelines and recommendations.
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Affiliation(s)
- Helen H R Kim
- Department of Radiology, Seattle Children's Hospital and University of Washington, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.
| | - Nathan C Hull
- Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 330 Longwood Avenue, Boston, MA 02115, USA
| | - Grace S Phillips
- Department of Radiology, Seattle Children's Hospital and University of Washington, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
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Boulos AK, Long RA. Fussiness and New-Onset Diarrhea for 2 Weeks in a 9-week-old Girl. Pediatr Rev 2021; 42:562-565. [PMID: 34599056 DOI: 10.1542/pir.2020-002691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Andrew K Boulos
- University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX
| | - Rachel A Long
- University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX
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Phipps WB, Rich AF, Rossanese M. Asymptomatic Enteric Duplication Cyst in a Geriatric Cat: Case Report and Review of the Literature. J Am Anim Hosp Assoc 2021; 57:133-138. [PMID: 33770172 DOI: 10.5326/jaaha-ms-7057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2020] [Indexed: 11/11/2022]
Abstract
An 11 yr old female neutered domestic shorthair presented for an 8 mo history of an asymptomatic abdominal mass. Computed tomography described an irregular, cystic structure closely associated with the duodenum, and focal ultrasonography confirmed the mass shared outer layers with the intestinal wall. Coeliotomy revealed the mass was originating from, and firmly adhered to, the antimesenteric border of the duodenum but was not communicating with the intestinal lumen. En bloc mass resection with omentalization was performed without small intestinal resection. Histopathology confirmed an enteric duplication cyst. The cat made a full recovery and remained asymptomatic postoperatively with no evidence of recurrence. A review of the literature confirms the duodenum to be the most common location of enteric duplication cysts in felines and that subtotal excision is curative in most cases. This differential should be considered in cases of cystic gastrointestinal structures in juvenile and adult felines, with or without associated clinical signs. In cases of luminal involvement or malignant transformation, intestinal resection and anastomosis is more appropriate. This report describes the presentation, investigations, and treatment of an asymptomatic duodenal duplication cyst in an adult feline and summarizes and compares current knowledge of the condition between veterinary and human literature.
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Israrahmed A, Verma V, Ahmad S, Yadav RR. Ileal duplication cyst with giant polypoidal gastric heterotropia. BMJ Case Rep 2021; 14:e245333. [PMID: 34493562 PMCID: PMC8424841 DOI: 10.1136/bcr-2021-245333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/04/2022] Open
Abstract
Enteric duplication cysts (EDCs) are congenital malformations of the gastrointestinal tract. EDCs can present as tubular or spherical cystic lesions of the abdomen. The tubular variant of EDC arises as an outpouching from the bowel wall, whereas the spherical variant rarely shows bowel communication. EDCs are known to harbour heterotopic pancreatic parenchyma or gastric mucosa. We present a case of EDC of the ileum (tubular type) with heterotopic gastric mucosa in a 7-year-old child who came with malena and abdominal discomfort. CT revealed focal abnormal dilatation of the ileal loop with polypoidal mucosal thickening. Differential diagnosis of lymphoma, bowel polyps and Meckel's diverticula with gastric heterotopia (GH) were considered. Subsequent surgery followed by histopathology revealed it to be EDC with GH. We discuss this case to familiarise radiologists with the atypical imaging features of EDC, to prevent misdiagnosis and initiate prompt treatment in appropriate clinical settings.
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Affiliation(s)
- Amrin Israrahmed
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Vikrant Verma
- Pathology, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sarfraz Ahmad
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Rajanikant R Yadav
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Yacoub JH, Clark JA, Paal EE, Manning MA. Approach to Cystic Lesions in the Abdomen and Pelvis, with Radiologic-Pathologic Correlation. Radiographics 2021; 41:1368-1386. [PMID: 34469214 DOI: 10.1148/rg.2021200207] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cystic lesions found in and around the peritoneal cavity can often be challenging to diagnose owing to significant overlap in imaging appearance between the different entities. When the cystic lesion can be recognized to arise from one of the solid abdominal organs, the differential considerations can be more straightforward; however, many cystic lesions, particularly when large, cannot be clearly associated with one of the solid organs. Cystic lesions arising from the mesentery and peritoneum are less commonly encountered and can be caused by relatively rare entities or by a variant appearance of less-rare entities. The authors provide an overview of the classification of cystic and cystic-appearing lesions and the basic imaging principles in evaluating them, followed by a summary of the clinical, radiologic, and pathologic features of various cystic and cystic-appearing lesions found in and around the peritoneal cavity, organized by site of origin. Emphasis is given to lesions arising from the mesentery, peritoneum, or gastrointestinal tract. Cystic lesions arising from the liver, spleen, gallbladder, pancreas, urachus, adnexa, or soft tissue are briefly discussed and illustrated with cases to demonstrate the overlap in imaging appearance with mesenteric and peritoneal cystic lesions. When approaching a cystic lesion, the key imaging features to assess include cyst content, locularity, wall thickness, and presence of internal septa, solid components, calcifications, or any associated enhancement. While definitive diagnosis is not always possible with imaging, careful assessment of the imaging appearance, location, and relationship to adjacent structures can help narrow the differential diagnosis. Online supplemental material is available for this article. ©RSNA, 2021.
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Affiliation(s)
- Joseph H Yacoub
- From the Department of Radiology, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007 (J.H.Y., J.A.C., M.A.M.); Pathology and Laboratory Medicine Service, VA Medical Center, Washington, DC (E.E.P.); Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC (E.E.P.); and American Institute for Radiologic Pathology, Silver Spring, Md (M.A.M.)
| | - Jennifer A Clark
- From the Department of Radiology, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007 (J.H.Y., J.A.C., M.A.M.); Pathology and Laboratory Medicine Service, VA Medical Center, Washington, DC (E.E.P.); Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC (E.E.P.); and American Institute for Radiologic Pathology, Silver Spring, Md (M.A.M.)
| | - Edina E Paal
- From the Department of Radiology, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007 (J.H.Y., J.A.C., M.A.M.); Pathology and Laboratory Medicine Service, VA Medical Center, Washington, DC (E.E.P.); Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC (E.E.P.); and American Institute for Radiologic Pathology, Silver Spring, Md (M.A.M.)
| | - Maria A Manning
- From the Department of Radiology, MedStar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007 (J.H.Y., J.A.C., M.A.M.); Pathology and Laboratory Medicine Service, VA Medical Center, Washington, DC (E.E.P.); Department of Pathology, George Washington University School of Medicine and Health Sciences, Washington, DC (E.E.P.); and American Institute for Radiologic Pathology, Silver Spring, Md (M.A.M.)
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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: 11] [Impact Index Per Article: 2.8] [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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Rolo A, Oliveira RC, Lima B, Barbosa A, Faustino I. Pancreatobiliary Adenocarcinoma in a Gastric Duplication Cyst: A Doubly Rare Diagnosis. Cureus 2021; 13:e16025. [PMID: 34336513 PMCID: PMC8319232 DOI: 10.7759/cureus.16025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 02/06/2023] Open
Abstract
Gastric duplication cyst (GDC) is a rare congenital abnormality and the development of malignant transformation in these lesions is even rarer, with only few reported cases worldwide to date. We hereby report an additional case of cancer arising from a GDC in a 54-year-old male. The patient’s chief complaints were abdominal pain and significant weight loss. Computed tomography and endoscopy ultrasonography (EUS) revealed a nodular formation with a cystic component, localized in the great gastric curvature and invading the spleen and left adrenal gland. The biopsy from EUS was inconclusive. After exploratory laparotomy, the patient was submitted to an en-bloc resection with partial gastrectomy, splenectomy and left adrenalectomy. Histopathologic examination revealed a cystic mass non-communicating with the gastric wall. Immunohistochemistry staining showed a moderately differentiated pancreatobiliary adenocarcinoma within a duplication cyst with lymphovascular and perineural invasion. The patient was proposed to adjuvant systemic treatment, however, after few months he developed metachronous metastasis. To our knowledge, this is the first case of adenocarcinoma with pancreatobiliary differentiation arising from a gastric duplication cyst.
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Affiliation(s)
- Ana Rolo
- Oncology Department, Hospital Senhora da Oliveira, Guimarães, PRT
| | - Rui Caetano Oliveira
- Pathologic Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Bárbara Lima
- Oncology Department, Hospital Senhora da Oliveira, Guimarães, PRT
| | - Ana Barbosa
- Oncology Department, Hospital Senhora da Oliveira, Guimarães, PRT
| | - Ilda Faustino
- Oncology Department, Hospital Senhora da Oliveira, Guimarães, PRT
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