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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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2
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Zain L, Sweity R, Alshawwa K, Bannoura S, Jaber B, Abu-Zaydeh O. Pancreatic duplication cyst misdiagnosed as distal pancreatic tumor: A case report and surgical approach. Front Surg 2023; 10:1148308. [PMID: 36969761 PMCID: PMC10036569 DOI: 10.3389/fsurg.2023.1148308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
Enteric duplication cysts (EDCs) are a benign and uncommon congenital malformation, with a nonspecific and extremely variable clinical presentation. EDCs associated with the pancreas are called pancreatic duplication cysts (PDCs). They are especially rare and can present with recurrent abdominal pain or even severe pancreatitis. These cysts often get confused with pancreatic neoplasms or pseudocysts, thus posing diagnostic and surgical challenges. Here, we report a case of a 20-year-old male patient with a 14-year history of recurrent abdominal pain and many hospital admissions, who had several imaging studies revealing a persistent focal heterogeneous lesion affecting the tail of the pancreas, surrounding a small pseudocyst. An ultrasound (U/S) guided biopsy was avoided due to the location of the mass. Surgical resection was carried out for the suspicion of malignancy and final pathology report showed benign findings while revealing that what was thought to be a pseudocyst turned out to be a gastric-type PDC, and after reviewing the available literature, we encountered 16 similar cases regarding misdiagnosing PDCs. We conclude that PDCs are very rare and have a variable clinical presentation as well as a likelihood of being confused with other pancreatic neoplasms. Therefore, PDCs need a high index of suspicion to avoid recurrent hospital admissions and unnecessary procedures due to the fact that sometimes a simple cystectomy is adequate.
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Affiliation(s)
- Lara Zain
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Raghad Sweity
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Khaled Alshawwa
- Department of General Surgery, Al-Makassed Charitable Society Hospital, Jerusalem, Palestine
- Correspondence: Khaled Alshawwa
| | - Sami Bannoura
- Department of Pathology, Al-Makassed Islamic Charitable Society Hospital, Jerusalem, Palestine
| | - Bashar Jaber
- Department of General Surgery, Al-Makassed Charitable Society Hospital, Jerusalem, Palestine
| | - Omar Abu-Zaydeh
- Department of General Surgery, Al-Makassed Charitable Society Hospital, Jerusalem, Palestine
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3
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Erman M, Celik A. Laparoscopic excision of a very rare isolated gastric enteric duplication cyst: case report and literature review. ANNALS OF PEDIATRIC SURGERY 2022. [DOI: 10.1186/s43159-022-00210-2] [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
Gastric duplication cysts are a very rare variant of all enteric duplications, and their isolated forms are much rarer developmental anomalies in the form of case reports only. In this study, a 4-month-old male patient, who was diagnosed with an intra-abdominal cystic mass in his antenatal examination and laparoscopic excision of the isolated gastric duplication was presented.
Case presentation
A 4-month-old male patient was born at 39 weeks of gestation, 3180 g. When a 37 × 17mm intra-abdominal cystic mass was detected in the detailed ultrasonography (USG) performed at the 20th week of his antenatal examination, he was followed up in another center with the preliminary diagnosis of mesenteric cyst and intestinal duplication cyst. It was learned that the patient had transient constipation and vomiting in his history. Physical examination revealed a mobile, smooth-surfaced 5-cm mass on palpation in the lower midline of the abdomen. Control ultrasonography revealed a lobulated contoured cystic lesion measuring 59 × 30 × 23 mm, with a multilayered wall structure and debris inside. In laparoscopy, the mass is mobile, thick-walled, cystic in appearance, isolated from surrounding tissues. It was observed that it was attached to the sigmoid colon mesentery with a handle. The thick peduncle containing the feeding vessels was closed and cut, preserving the mesentery. Thick mucoid cyst contents were aspirated with a percutaneous needle. The shrinking cyst was removed from the abdomen by enlarging the working opening of 5 mm. The macroscopic appearance was consistent with intestinal duplication cyst. The patient was fed orally at the 2nd hour postoperatively and was discharged at the 10th hour. In the pathological examination, gastric duplication cyst was diagnosed due to the type of gastric lining epithelium. No recurrence or additional pathology was detected in the control ultrasonography in the 6-month follow-up postoperatively.
Conclusion
Laparoscopic exploration should be considered as the first surgical option in asymptomatic, growing intra-abdominal cystic masses with a preliminary diagnosis of duplication cysts. The advantages of laparoscopy can make important contributions to patient management.
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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: 2] [Impact Index Per Article: 0.5] [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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Zhang Z, Huang X, Chen Q, Li D, Zhou Q, Huang J, Feng Y, Hu J, Qin H. Small intestine duplication cyst with recurrent hematochezia: a case report and literature review. BMC Gastroenterol 2021; 21:246. [PMID: 34074253 PMCID: PMC8170808 DOI: 10.1186/s12876-021-01627-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/25/2021] [Indexed: 01/07/2023] Open
Abstract
Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.
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Affiliation(s)
- Zhicheng Zhang
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiaowei Huang
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qian Chen
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Demin Li
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Zhou
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jinjin Huang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongdong Feng
- Department of Gastrointestinal Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junbo Hu
- Department of Gastrointestinal Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hua Qin
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Siragusa L, Pathirannehalage Don C, Benavoli D, Diacinti D, Manenti G, Pocci M, Palmieri G, Rossi P. Completely Isolated Enteric Duplication Cyst and Incidental Neuroendocrine Tumor of the Appendix: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e923988. [PMID: 32829376 PMCID: PMC7467633 DOI: 10.12659/ajcr.923988] [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: 12/04/2022]
Abstract
Patient: Female, 26-year-old Final Diagnosis: Completely isolated enteric duplication cyst and appendiceal neuroendocrine tumor Symptoms: Dysmenorrhea Medication: — Clinical Procedure: — Specialty: Oncology • Surgery
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Affiliation(s)
- Leandro Siragusa
- Department of Surgery, Tor Vergata University of Rome, Rome, Italy
| | | | | | - Davide Diacinti
- Department of Radiology, Tor Vergata University of Rome, Rome, Italy
| | - Guglielmo Manenti
- Department of Radiology, Tor Vergata University of Rome, Rome, Italy
| | - Marco Pocci
- Histopathologic Unit, Tor Vergata University of Rome, Rome, Italy
| | | | - Piero Rossi
- Department of Surgery, Tor Vergata University of Rome, Rome, Italy
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Xiang L, Lan J, Chen B, Li P, Guo C. Clinical characteristics of gastrointestinal tract duplications in children: A single-institution series review. Medicine (Baltimore) 2019; 98:e17682. [PMID: 31689788 PMCID: PMC6946480 DOI: 10.1097/md.0000000000017682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Due to the various presentations of gastrointestinal tract duplications (GTD), diagnosing and management for this disease might be varied and difficult. We intend to improve the experiences for these difficult, in terms of the clinical presentations, diagnostic investigations, management.We reviewed recent literature and retrospectively analyzed 72 pediatric patients with enteric duplication. Diagnosis was confirmed by surgery and pathological examination for imaging characteristics and clinical and pathological features.The ages of patients ranged from one month to 12.5 years. The clinical presentations of the patients included 57 cases with abdominal pain, followed with nausea or vomiting, abdominal distension, etc. All of the patients were diagnosed by ultrasonography, and most of them presented as intra-abdominal cystic masses. Four cases were diagnosed with the cysts other than GTDs, like, mesenteric cyst, chledochal cyst and abscess, and so on. Computed tomography was performed on 65 patients. X-rays and barium meal showed the outline of the cyst structure, with intestinal displacement due to the pressure from the cyst. Among the 72 cases of enteric duplication, 45 were located with ileocecal area, 41 were ileal and 8 were colonic duplications.Enteric duplication is very rare in children and is prone to misdiagnosis. The preoperative diagnosis of enteric duplication can be improved through comprehensive analysis of various imaging exams and closely related clinical presentations.
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Affiliation(s)
- Li Xiang
- Department of Pediatric General Surgery
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing
| | | | - Bailin Chen
- Department of Pediatric General Surgery
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing
| | - Ping Li
- Department of Ultrasound, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, PR China
| | - Chunbao Guo
- Department of Pediatric General Surgery
- Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing
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8
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Tanaka Y, Nakai G, Tomiyama H, Kurisu Y, Narumi Y. A case report of ectopic pancreatitis in an isolated enteric duplication cyst. BMC Surg 2019; 19:64. [PMID: 31215413 PMCID: PMC6582472 DOI: 10.1186/s12893-019-0531-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 06/12/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Isolated enteric duplication cyst is an intestinal duplication cyst found in a distant location from the intestinal tract and it is said to have its own blood supply. Meckel's diverticulm is considered as an antimesenteric structure and has its own blood supply. However, there are some reported cases of Meckele's diverticum in the mesenteric side. Ectopic pancreas may be found in both entities. CASE PRESENTATION A 5-year-old girl presented with increasing abdominal pain around the umbilicus. On laboratory investigation serum pancreatic enzymes and C-reactive protein were elevated. Abdominal computed tomography (CT) revealed a normal pancreas but a cystic lesion in the mesentery of the ileum. A nodule with a marked enhancement was observed in the wall of the lesion. During the laparoscopy, the lesion was found at the root of the mesentery and was distant from the ileum. The lesion was resected suspecting an abscess. Pathologically, the wall of the lesion consisted of small bowel like tissue, and pancreatic tissue was seen beneath the mucosa. There were some post inflammatory changes in the pancreatic tissue. Retrospectively on thin slice enhanced CT, an independent blood supply was noted. Based on these findings, a diagnosis of ectopic pancreatitis in an iliac intestinal duplication cyst was made. CONCLUSION Isolated enteric duplication cyst in the root of ileal mesentery and mesenteric Meckel's diverticulum have similarities. In the present case, the diagnosis of isolated enteric duplication cyst was made since it was found distant from the ileum. It is important to consider the possibility of ectopic pancreatitis when serum pancreatic enzymes are elevated even when the pancreas appears normal.
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Affiliation(s)
- Yoshikazu Tanaka
- Department of Radiology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan.
| | - Go Nakai
- Department of Radiology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan
| | - Hideki Tomiyama
- Department of Surgery, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan
| | - Yoshitaka Kurisu
- Department of Pathology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan
| | - Yoshifumi Narumi
- Department of Radiology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, Japan
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9
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Ebinuma S, Ohba G, Nakayama M, Yamamoto H. Isolated alimentary tract duplication presenting as a prenatal abdominal cyst. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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10
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A Retroperitoneal Isolated Enteric Duplication Cyst Mimicking a Teratoma: A Case Report and Literature Review. Case Rep Radiol 2017; 2016:6976137. [PMID: 28083153 PMCID: PMC5204112 DOI: 10.1155/2016/6976137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/27/2016] [Indexed: 01/07/2023] Open
Abstract
Enteric duplication cysts lacking anatomic association with the gastrointestinal tract are called isolated enteric duplication cysts (IEDCs). We present an atypical case of a retroperitoneal IEDC with a tortuous tubular complex shape that enfolded the surrounding retroperitoneal fat and mimicked a retroperitoneal teratoma. Multiplanar reconstruction images should be used to evaluate such a lesion correctly. A tortuous tubular complex shape could be a key finding to differentiate from other retroperitoneal cysts.
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11
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Nguyen PT, Simper NB, Childers CK. Isolated omental duplication cyst with respiratory epithelium & pancreatic glands: Case report & review of literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Risk-reduction surgery in pediatric surgical oncology: A perspective. J Pediatr Surg 2016; 51:675-87. [PMID: 26898681 DOI: 10.1016/j.jpedsurg.2016.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 01/21/2016] [Accepted: 01/21/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE A small percentage of pediatric solid cancers arise as a result of clearly identified inherited predisposition syndromes and nongenetic lesions. Evidence supports preemptive surgery for children with genetic [multiple endocrine neoplasia type 2 (MEN2), familial adenomatous polyposis syndrome (FAP), hereditary nonpolyposis colorectal cancer (HNPCC), and hereditary diffuse gastric cancer (HDGC) and nongenetic [thyroglossal duct cysts (TGDC), congenital pulmonary airway malformations (CPAM), alimentary tract duplication cysts (ATDC), and congenital choledochal cysts (CCC)] developmental anomalies. Our aim was to explore the utility of risk reduction surgery to treat and prevent cancer in children. METHODS A systematic review of the available peer-reviewed literature on PubMed was performed using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) search strategy, where possible. Search items included "risk reduction surgery", "hereditary cancer predisposition syndrome", "multiple endocrine neoplasia type 2", "familial adenomatous polyposis", "hereditary nonpolyposis colorectal cancer", "hereditary diffuse gastric cancer", "thyroglossal duct cysts", congenital pulmonary airway malformations", "alimentary tract duplication cysts", "malignant transformation", and "guidelines". RESULTS We identified 67 articles that met the inclusion criteria describing the indications for prophylactic surgery in surgical oncology. For the genetic predisposition syndromes, 7 studies were related to professional endorsed guidelines, 7 were related to surgery for MEN2, 11 were related to colectomy for FAP, 6 were related to colectomy for HNPCC, and 12 related to gastrectomy for HDGC. Articles for the nongenetic lesions included 5 for techniques related to TGDC resection, 9 for surgery for CPAMs, and 10 for resection of ATDCs. Guidelines and strategies varied significantly especially related to the extent and timing of surgical intervention; the exception was for the timing of thyroidectomy in children with MEN2. CONCLUSION Current evidence supporting prophylactic surgery in the management of pediatric cancer predisposition syndromes and nongenetic lesions is best delineated for thyroidectomy to prevent medullary thyroid cancer in children with MEN2 (Strength of Recommendation Grade B/C). Despite the lack of pediatric specific evidence-based recommendations regarding the appropriate extent and timing for risk-reduction surgery for FAP, HNPCC, HDGC and nongenetic anomalies, our review represents an opportunity towards understanding the postgenomic development of these lesions and provides current indications and techniques for preemptive cancer prevention surgery in children.
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Turkyilmaz C, Onal E, Atalay Y, Sonmez K, Turkyilmaz Z, Koc E, Ergenekon E, Konus O. Two isolated giant gastric duplication cysts in thorax in a newborn. Scott Med J 2014; 58:e28-30. [PMID: 23960067 DOI: 10.1177/0036933013482662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report a case of a newborn with severe respiratory distress since birth with two giant intrathoracic and separate eneteric duplication cysts in right hemithorax. On day 19, the intrathoracic cysts were removed, and the baby was discharged on his 22nd day of life. Histologic findings confirmed the diagnosis of a gastric duplication cyst. This report is the first case of two isolated, separated and giant right intrathoracic gastric duplication cysts in literature. The diagnostic values of radiological evaluation and surgical and pathological management for precise diagnosis are discussed.
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Affiliation(s)
- C Turkyilmaz
- Department of Neonatology, Gazi University Medical Faculty, Turkey.
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14
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Atalar MH, Cankorkmaz L, Ozer H, Koyluoglu G. A huge duplication cyst of the ileum. Pol J Radiol 2013; 78:70-3. [PMID: 24115964 PMCID: PMC3789938 DOI: 10.12659/pjr.884012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 06/30/2013] [Indexed: 11/29/2022] Open
Abstract
Background: Massive unilocular intraabdominal cysts in children are rare. Alimentary tract duplications can present diagnostic and therapeutic difficulties. Although they can occur anywhere from the mouth to the anus, they are commonly seen in relation to the ileum. We herein present an unusual case of duplication cyst itself occupying virtually all of the available intraabdominal volume. It appeared to be an enteric duplication cyst of ileal origin. Case Report: A 3-month-old girl was admitted to our hospital for investigation of progressive abdominal distension and biliary vomiting. Plain radiography of the abdomen showed normal air-fluid level in the stomach and paucity of gases in rest of the abdomen. Magnetic resonance imaging showed a huge, homogenous cyst extending from the xiphisternum down to the pelvis. The cyst was excised completely. Macroscopic examination and histologic findings confirmed the diagnosis of a huge enteric duplication cyst arising from the ileum. Conclusions: Enteric duplication cyst should be considered in a patient with an abdominal cystic mass. Radiologist must take into account patient age, clinical parameters, and imaging findings to identify the likely etiology of a cystic mass.
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Affiliation(s)
- Mehmet H Atalar
- Department of Radiology, Cumhuriyet University School of Medicine, Sivas, Turkey
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15
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Souzaki R, Ieiri S, Kinoshita Y, Nishie A, Koga Y, Kuda M, Oda Y, Hara T, Hashizume M, Taguchi T. Laparoscopic resection of an isolated retroperitoneal enteric duplication in an infant. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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17
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Multiple duplication cysts diagnosed prenatally: case report and review of the literature. Pediatr Surg Int 2013; 29:397-400. [PMID: 23371299 DOI: 10.1007/s00383-012-3231-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2012] [Indexed: 02/07/2023]
Abstract
Enteric duplication cysts (EDC) are typically solitary lesions that occur throughout the alimentary tract. Postnatal diagnosis is often prompted when complications occur from bleeding, obstruction, or infection. We present a case of multiple EDC diagnosed prenatally, managed with prenatal and neonatal follow-up and resection in infancy. Prenatal detection allowed for optimal management prior to the development of symptoms or complications.
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18
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Infected completely isolated enteric duplication cyst management with percutaneous drainage and surgical excision after retreat of infection: a case report. Case Rep Surg 2013; 2013:108126. [PMID: 23476873 PMCID: PMC3580896 DOI: 10.1155/2013/108126] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/09/2013] [Indexed: 01/07/2023] Open
Abstract
Duplication cysts (DCs) of alimentary tract are rare congenital malformations. They are firmly attached to the wall of the gastrointestinal tract and they are supplied by surrounding mesenteric blood vessels. More than 80% of cases occur before the age of two years and only a minority of cases present in adulthood. “Completely isolated duplication” of the alimentary tract is an extremely rare variety of gastrointestinal duplications. They have gastrointestinal epithelial and wall characteristics without an anatomic association with the alimentary tract. Their main characteristic is that they have their own blood supply. A 20-year-old male was admitted to our department with symptoms persisting for a period of one week prior to admission, which included abdominal pain, fever, and a palpable abdominal mass. CT revealed an unexplained intraperitoneal abscess. This case represents a rare clinical example of infected isolated duplication cyst managed with percutaneous drainage and surgical excision of the cyst 3 weeks later. To the best of our knowledge, this is the first reported case to use this approach.
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Pant N, Grover JK, Madan NK, Chadha R, Agarwal K, Choudhury SR. Completely isolated enteric duplication cyst associated with a classic enterogenous duplication cyst. J Indian Assoc Pediatr Surg 2012; 17:68-70. [PMID: 22529551 PMCID: PMC3326825 DOI: 10.4103/0971-9261.93966] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
This report describes an 18-month-old boy with a completely isolated duplication cyst (CIDC) of the ileum associated with another classic enteric duplication cyst in the adjacent bowel and presenting as an acute abdomen due to torsion of the pedicle of the CIDC. Cysts excision was curative.
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Affiliation(s)
- Nitin Pant
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
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Pachl M, Patel K, Bowen C, Parikh D. Retroperitoneal gastric duplication cyst: a case report and literature review. Pediatr Surg Int 2012; 28:103-5. [PMID: 22138979 DOI: 10.1007/s00383-011-3036-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2011] [Indexed: 02/05/2023]
Abstract
A rare case of retroperitoneal gastric duplication is reported and discussed. An intra-abdominal cyst was detected at 31 weeks gestation and was followed up prenatally as a left sided duplex kidney. Post-natal ultrasound however, showed a normal kidney, but a cyst with features of enteric duplication in the left upper quadrant adjacent and compressing the kidney. Surgery was carried out during infancy and a retroperitoneal cyst was excised that contained heterotrophic gastric mucosa.
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Affiliation(s)
- Max Pachl
- Department of Paediatric Surgery, Birmingham Children's Hospital NHS Trust, Steelhouse Lane, Birmingham, B4 6NH, UK
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21
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Fiorani C, Scaramuzzo R, Lazzaro A, Biancone L, Palmieri G, Gaspari AL, Sica G. Intestinal duplication in adulthood: A rare entity, difficult to diagnose. World J Gastrointest Surg 2011; 3:128-30. [PMID: 22007281 PMCID: PMC3192219 DOI: 10.4240/wjgs.v3.i8.128] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 06/06/2011] [Accepted: 06/15/2011] [Indexed: 02/06/2023] Open
Abstract
Duplications of the alimentary tract (ATD) are rare congenital anomalies often found early in life. They may occur anywhere in the intestinal tract but the ileum is the most frequently affected site. Clinical presentation of ATD in adults is variable and because these lesions occur so infrequently they are rarely suspected. In the present report we describe a case of ileal duplication in a 61-year-old patient with Crohn’s disease. Despite various radiological investigations and medical consultations, the diagnosis was only made on the surgical specimen.
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Affiliation(s)
- Cristina Fiorani
- Cristina Fiorani, Rosa Scaramuzzo, Alessandra Lazzaro, Achille L Gaspari, Giuseppe Sica, Department of Surgical Science, Tor Vergata University Hospital, 00133 Rome, Italy
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22
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Sequestrated tubular duplications of small bowel. J Pediatr Surg 2011; 46:e9-10. [PMID: 21683191 DOI: 10.1016/j.jpedsurg.2011.02.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 02/15/2011] [Accepted: 02/25/2011] [Indexed: 11/23/2022]
Abstract
Duplications of bowel are well-known gastrointestinal tract anomalies. However, sequestrated duplications are very uncommon. Two sequestrated tubular duplications of the small bowel, separate from the ileum with autonomous blood supply and classic histologic features of small bowel are presented. Two sequestrated duplications in the same child are quite rare and have not been previously reported.
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23
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Ko SF, Ng SH, Huang FC, Sung MT, Hsieh CS. Postprandial abdominal pain owing to isolated enteric duplication cyst in the superior mesenteric artery root: sonographic and magnetic resonance imaging features. J Pediatr Surg 2011; 46:772-775. [PMID: 21496554 DOI: 10.1016/j.jpedsurg.2010.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 12/21/2010] [Accepted: 12/22/2010] [Indexed: 01/11/2023]
Abstract
A 7-year-old girl presented to the emergency department with postprandial abdominal pain. An abdominal sonogram revealed a retroperitoneal septated cystic lesion. Magnetic resonance imaging showed a septated cystic lesion in the superior mesenteric artery (SMA) root with a vessel originating from the proximal SMA supplying the cyst wall and a deformed adjacent aortic contour. A laparotomy was performed and confirmed the presence of an isolated enteric duplication cyst with its own blood supply from the SMA and marked perilesional adhesions to the duodenal loop and aorta. Histopathologic study was consistent with a duplication. To our knowledge, this is the first report of isolated enteric duplication cyst in the superior mesenteric root with perilesional adhesion leading to postprandial abdominal pain, which was successfully relieved after surgery.
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Affiliation(s)
- Sheung-Fat Ko
- Department of Radiology, College of Medicine, Chang Gung University, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 333, Taiwan.
| | - Shu-Hang Ng
- Department of Radiology, College of Medicine, Chang Gung University, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 333, Taiwan
| | - Fu-Chen Huang
- Department of Pediatrics, College of Medicine, Chang Gung University, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 333, Taiwan
| | - Ming-Tse Sung
- Department of Pathology, College of Medicine, Chang Gung University, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 333, Taiwan
| | - Chie-Song Hsieh
- Department of Pediatric Surgery, College of Medicine, Chang Gung University, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 333, Taiwan; Department of Pediatric Surgery, Pingtong Christian Hospital, Pingtong 999, Taiwan
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24
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Type IV jejunal atresia with an unusual variation of enteric duplication: report of a case. Surg Today 2010; 41:130-2. [PMID: 21191705 DOI: 10.1007/s00595-009-4201-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Accepted: 08/06/2009] [Indexed: 10/18/2022]
Abstract
We report a rare case of type IV jejunal atresia with enteric duplication and multiple diverticuli, found in a 3-day-old baby girl. To our knowledge, this association has never been reported before.
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25
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Lee JU, Kim JO, Kim SJ, Sul HJ. Completely Isolated Enteric Duplication Cyst Presenting as an Inguinal Hernia. KOREAN JOURNAL OF PATHOLOGY 2010. [DOI: 10.4132/koreanjpathol.2010.44.2.204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jung Uee Lee
- Department of Hospital Pathology, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea
| | - Jong Ok Kim
- Department of Hospital Pathology, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea
| | - Say June Kim
- Department of General Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea
| | - Hye Jung Sul
- Department of Hospital Pathology, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea
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26
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Tomas D, Zovak M, Cicek S, Sulentić P, Jukić Z, Kruslin B. Mucinous cystadenoma arising in an isolated ileal duplication cyst. J Gastrointest Cancer 2009; 38:127-30. [PMID: 19089665 DOI: 10.1007/s12029-008-9023-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION A 64-year-old woman with a 2-year history of bilateral breast carcinoma with axillary node metastasis and chemotherapy was admitted to our hospital due to tumor attached to the ileum, discovered during the routine control examination. DISCUSSION Computerized axial tomography showed oval cystic tumor in terminal ileum that measured 7 cm in the largest diameter and shared peritoneal coat with small intestine and was filled with dense fluid. Tumor abutted intestine but did not communicate with intestinal lumen. The surgical procedure was simple because cyst was attached to the antimesenteric side of the terminal ileum and did not communicate with the adjacent intestine. Pathohistological examination showed mucinous cystadenoma with high-grade epithelial dysplasia in the isolated ileal duplication cyst. The presence of epithelial dysplasia found in duplication cyst suggested potential to undergo malignant transformation. CONCLUSION In conclusion, we report a unique case of mucinous cystadenoma arising in isolated ileal duplication cyst. This case report expands the potential range of clinical variability of alimentary tract duplications. Surgical removal of alimentary tract duplication in patients without symptoms is also recommended because many potential complications or even malignant transformation may result from these anomalies.
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Affiliation(s)
- Davor Tomas
- Ljudevit Jurak Department of Pathology, Sestre milosrdnice University Hospital, Vinogradska cesta 29, 10000, Zagreb, Croatia.
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27
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Duperron C, Martin-Phipps T, Bernard P, Esquis P, Naouri A, Odet E. [Isolated ileal duplication with laparoscopic repair: a rare case]. ACTA ACUST UNITED AC 2008; 145:513-5. [PMID: 19106879 DOI: 10.1016/s0021-7697(08)74680-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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28
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Abstract
A rare case of a completely isolated, alimentary tract duplication cyst in a 27-day-old neonate is reported. The duplication cyst was detected on antenatal fetal ultrasound and magnetic resonance (MR) imaging at 27 weeks' gestational age. At surgery, the duplication cyst was in a retroperitoneal site with no apparent communication between the cyst and any portion of the alimentary tract. On histopathological examination, the diagnosis was a gastric duplication cyst. The patient's postoperative course was uneventful. There have been eight cases of completely isolated duplication reported in the literature, of which seven were detected during the prenatal or neonatal period. No previous report in the English literature has described the fetal MR imaging findings of this type of duplication cyst.
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29
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Tatekawa Y, Hoshino N, Urita Y, Kudou S, Komuro H, Hori T, Kaneko M. Omental pseudocyst formation associated with perforated gastric duplication: a case report. J Pediatr Surg 2008; 43:e27-9. [PMID: 18778984 DOI: 10.1016/j.jpedsurg.2008.04.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Revised: 04/11/2008] [Accepted: 04/11/2008] [Indexed: 10/21/2022]
Abstract
We present a case of omental pseudocyst associated with a perforated gastric duplication. A boy (2.5 years old) with an abdominal mass was admitted because thick-walled and thin-walled double cysts were identified on computed tomography and magnetic resonance imaging. At laparotomy, the double cysts were interconnected and located in the omentum with no communication to the stomach. Microscopic examination showed a thick-walled cyst composed solely of gastric tissue with muscle layers divided at the stricture between the 2 cysts and a thin-walled cyst without a true endothelial lining. Gastric duplications can be complicated with perforation and malignancy, and primary surgery is the first choice of treatment.
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Affiliation(s)
- Yukihiro Tatekawa
- Department of Pediatric Surgery, Graduate School of Comprehensive Human Sciences and University Hospital, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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Daher P, Karam L, Riachy E. Prenatal diagnosis of an intrathoracic gastric duplication: a case report. J Pediatr Surg 2008; 43:1401-4. [PMID: 18639707 DOI: 10.1016/j.jpedsurg.2008.03.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 03/14/2008] [Accepted: 03/17/2008] [Indexed: 02/08/2023]
Abstract
We report an intrathoracic gastric duplication cyst detected antenatally on obstetrical ultrasonography at 33 weeks of gestation. After birth, the newborn was directly intubated. At day 19, the intrathoracic cyst was removed, and the patient discharged on his 27th day of life. Histologic findings confirmed the diagnosis of a gastric duplication cyst. This appears to be the first reported case of an intrathoracic gastric duplication detected antenatally. Intrathoracic gastric duplication should be among the differential diagnosis of any mediastinal cyst discovered antenatally; its detection allows appropriate management at birth.
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Affiliation(s)
- Paul Daher
- Department of Pediatric Surgery, Hotel Dieu de France University Hospital-Beirut, Saint Joseph University, Achrafieh, PO Box 16-6830, Beirut, Lebanon.
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31
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Nakazawa N, Okazaki T, Miyano T. Prenatal detection of isolated gastric duplication cyst. Pediatr Surg Int 2005; 21:831-4. [PMID: 16200403 DOI: 10.1007/s00383-005-1517-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2005] [Indexed: 01/07/2023]
Abstract
We present a rare case of gastric duplication cyst that was suspected prenatally. A routine prenatal ultrasonography (US) showed an abdominal cyst with peristalsis and a provisional diagnosis of enteric duplication was made. A healthy male infant was born at 39 weeks gestation and postnatal US identified a cyst, 5x3x2 cm in size, adjacent to the pancreas. At laparotomy, a cyst was found located in the lesser sac, but completely separated from the stomach, and partially adhered to the body of the pancreas and the crura of the diaphragm. Total excision of the cyst was successful. Histopathologic examination confirmed that the cyst wall consisted solely of normal gastric tissue with erosions. To the best of our knowledge, this is the first report of an isolated gastric duplication cyst that was detected prenatally and resected during the neonatal period.
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Affiliation(s)
- Nana Nakazawa
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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32
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Simsek A, Zeybek N, Yagci G, Kaymakcioglu N, Tas H, Saglam M, Cetiner S. Enteric and rectal duplications and duplication cysts in the adult. ANZ J Surg 2005; 75:174-6. [PMID: 15777401 DOI: 10.1111/j.1445-2197.2005.03323.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Alimentary tract duplication and duplication cysts are rare congenital malformations. The ileum is the most frequently affected site. However, alimentary tract duplication and duplication cysts can occur at any point along the gastrointestinal tract. Early diagnosis and prompt surgical treatment is the best way to prevent associated morbidity. This article presents the cases of three patients admitted to Gulhane Military Medical Academy with signs of acute abdomen, intra-abdominal mass and chronic abdominal pain. These patients were found to have enteric duplication, duplication cyst and/or retro-rectal cyst. The literature on alimentary tract duplications is reviewed.
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Affiliation(s)
- Abdurrahman Simsek
- Department of Surgery, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
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Abstract
Two rare cases of completely isolated duplication cysts are reported. A large but asymptomatic tubular cyst hanging from a narrow pedicle arising from the base of the terminal ileal mesentery was removed in a 6-day-old boy along with correction of associated malrotation. Multiple isolated duplication cysts located in the thorax and abdomen were excised in a 10-week-old infant. Both children remained asymptomatic after surgery.
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Affiliation(s)
- Prema Menon
- Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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