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Sghaier A, Lamloum E, Debaibi M, Rejab SB, Sridi A, Chouchene A. An epigastric mass? And what if it was an intra-abdominal esophageal duplication cyst: Case report. Int J Surg Case Rep 2023; 106:108295. [PMID: 37156202 PMCID: PMC10183657 DOI: 10.1016/j.ijscr.2023.108295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Duplication of the alimentary tract are uncommon congenital malformations that may be found anywhere from mouth to anus. Esophageal cystic duplication is a congenital cystic malformation of the alimentary tract consisting of a duplication of the segment of the esophagus to which it is adjacent. CASE PRESENTATION We report the case of a 29-year-old female who had complained of intermittent epigastric pain and post prandial nausea for several weeks. Physical examination was without particularity except for the presence of abdominal epigastric mass. Transabdominal sonography combined with CT scan showed an epigastric cyst with no topographic relation to the pancreas measuring about 80 mm in diameter. Because of persistence of the epigastric pain and the nausea we decided to operate the patient. Histological exam than showed that the cystic mass was in fact an esophageal cystic duplication with no histological signs of malignancy. CLINICAL DISCUSSION Here we describe a case of intra-abdominal esophageal duplication cyst in adult patient. Most of duplications cause symptoms in infancy or early childhood. Digestive duplication revealed at adulthood is a condition considered rare. CONCLUSION Esophageal duplication cysts are uncommon developmental lesions arising from the primitive foregut, when diagnosed or encountered incidentally. The diagnosis of this anomaly in adulthood is exceptional and requires surgery.
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Affiliation(s)
- Asma Sghaier
- Hospital of The Forces and The Security of Interior La Marsa Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis AlManar, Tunisia; Departement of General Surgery, Tunisia.
| | - Eya Lamloum
- Hospital of The Forces and The Security of Interior La Marsa Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis AlManar, Tunisia; Departement of General Surgery, Tunisia
| | - Mehdi Debaibi
- Hospital of The Forces and The Security of Interior La Marsa Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis AlManar, Tunisia; Departement of General Surgery, Tunisia
| | - Sarra Ben Rejab
- Hospital of The Forces and The Security of Interior La Marsa Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis AlManar, Tunisia; Laboratory of Histopathology and Cytogenetics, Tunisia
| | - Azza Sridi
- Hospital of The Forces and The Security of Interior La Marsa Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis AlManar, Tunisia; Departement of General Surgery, Tunisia
| | - Adnene Chouchene
- Hospital of The Forces and The Security of Interior La Marsa Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis AlManar, Tunisia; Departement of General Surgery, Tunisia
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Oyama S, Tanaka K, Moriyama M, Nonaka T, Tominaga T, Sawai T, Kinoshita N, Nagayasu T. Laparoscopic resection of an intra-abdominal esophageal duplication cyst in the ileum: a case report. Surg Case Rep 2022; 8:219. [PMID: 36484876 PMCID: PMC9733750 DOI: 10.1186/s40792-022-01576-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Esophageal duplication cyst (EDC) is a type of gastrointestinal duplication cyst that involves congenital malformations of the gastrointestinal tract. EDCs are frequently found in the mediastinum and thoracoabdominal region, but rarely occur in the abdominal cavity. However, intra-abdominal EDCs are frequently found in the upper abdomen near the abdominal esophagus. Here, we report, for the first time, a case of intra-abdominal EDC that occurred in the ileum. CASE PRESENTATION A 14-year-old female patient presented to our hospital with complaints of epigastric pain and vomiting. Abdominal computed tomography (CT) revealed a cystic tumor in the pelvis, suspected of ovarian origin. She was admitted to our gynecology department and underwent emergency surgery. The laparoscopic examination revealed that both ovaries were intact and that a primary tumor had developed from the ileal mesentery. Since the patient's condition was not urgent at the time of the gynecological surgery, the procedure was completed by only performing exploratory laparotomy; the patient was admitted to our department after the surgery. Pelvic magnetic resonance imaging performed on the next day revealed a cystic mass measuring 90 × 65 mm with a smooth margin and homogeneous signal intensity, arising posterior to the uterus. The mass was suspected as an intestinal duplication cyst. On another day, after the examinations were completed, we resected the portion of the small intestine containing the tumor by laparoscopy. The patient had a successful postoperative course and was discharged on the 5th postoperative day. Histological examination showed that the cyst was lined by stratified squamous epithelium, contained esophageal glands, and had a two-layer muscularis propria. Therefore, a diagnosis of intra-abdominal EDC was performed. CONCLUSIONS An intra-abdominal EDC cyst is relatively rare; this is the first case reported at the distal ileum.
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Affiliation(s)
- Shosaburo Oyama
- Department of Surgery, Saiseikai Nagasaki Hospital, 2-5-1 Katafuchi, Nagasaki, 850-0003 Japan ,grid.174567.60000 0000 8902 2273Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kenji Tanaka
- Department of Surgery, Saiseikai Nagasaki Hospital, 2-5-1 Katafuchi, Nagasaki, 850-0003 Japan
| | - Masaaki Moriyama
- Department of Surgery, Saiseikai Nagasaki Hospital, 2-5-1 Katafuchi, Nagasaki, 850-0003 Japan ,grid.174567.60000 0000 8902 2273Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Takashi Nonaka
- grid.174567.60000 0000 8902 2273Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Tetsuro Tominaga
- grid.174567.60000 0000 8902 2273Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Terumitsu Sawai
- grid.174567.60000 0000 8902 2273Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Naoe Kinoshita
- Department of Diagnostic Pathology, Saiseikai Nagasaki Hospital, 2-5-1 Katafuchi, Nagasaki, 850-0003 Japan
| | - Takeshi Nagayasu
- grid.174567.60000 0000 8902 2273Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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Martins C, Sousa P, Araújo T, Castro-Poças F, Pedroto I. Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2016; 24:193-197. [PMID: 29255750 DOI: 10.1159/000452696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/10/2016] [Indexed: 11/19/2022]
Abstract
The differential diagnosis of mediastinal masses involves many benign and malignant conditions, such as lymphadenopathies and cystic lesions. Metastatic mediastinal adenopathies are usually due to lung, esophagus, and stomach cancer and, rarely, due to colorectal cancer. Gastrointestinal duplication cysts are uncommon inherited lesions usually diagnosed during childhood and may involve the esophagus in 20% of cases. In adults, they are usually asymptomatic and diagnosed incidentally. We report the case of a 54-year-old male who recently underwent sigmoidectomy due to an obstructive colon adenocarcinoma. Staging computed tomography scan showed a hypodense lesion in the posterior mediastinum suggestive of metastatic adenopathy. Endoscopic ultrasound revealed a homogeneous and hypoechogenic lesion with intramural location in the upper esophagus, suggestive of a duplication esophageal cyst. Given the oncologic background and to exclude metastatic disease, endoscopic ultrasound-guided fine needle aspiration was performed, and a mucinous fluid was aspirated. The cytologic examination supported the ultrasonographic diagnostic hypothesis. This case highlights the role of endoscopic ultrasound in the differential diagnosis of mediastinal masses, particularly in oncologic patients, in order to rule out more ominous lesions.
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Affiliation(s)
- Cláudio Martins
- Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Paula Sousa
- Gastroenterology Department, Hospital de São Teotónio, Centro Hospitalar de Tondela/Viseu, Viseu, Portugal
| | - Tarcísio Araújo
- Gastroenterology Department, Hospital Geral de Santo António, Centro Hospitalar do Porto, Porto, Portugal
| | - Fernando Castro-Poças
- Gastroenterology Department, Hospital Geral de Santo António, Centro Hospitalar do Porto, Porto, Portugal.,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Isabel Pedroto
- Gastroenterology Department, Hospital Geral de Santo António, Centro Hospitalar do Porto, Porto, Portugal.,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
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Laparoscopic resection of an intra-abdominal esophageal duplication cyst: a case report and literature review. Case Rep Surg 2015; 2015:940768. [PMID: 25883826 PMCID: PMC4391505 DOI: 10.1155/2015/940768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 03/16/2015] [Indexed: 01/05/2023] Open
Abstract
Duplication of the alimentary tract is a rare congenital malformation that occurs most often in the abdominal region, whereas esophageal duplication cyst develops typically in the thoracic region but occasionally in the neck and abdominal regions. Esophageal duplication cyst is usually diagnosed in early childhood because of symptoms related to bleeding, infection, and displacement of tissue surrounding the lesion. We recently encountered a rare adult case of esophageal duplication cyst in the abdominal esophagus. A 50-year-old man underwent gastroscopy, endoscopic ultrasonography, computed tomography, and magnetic resonance imaging to investigate epigastric pain and dysphagia that started 3 months earlier. Imaging findings suggested esophageal duplication cyst, and the patient underwent laparoscopic resection followed by intraoperative esophagoscopy to reconstruct the esophagus safely and effectively. Histopathological examination of the resected specimen revealed two layers of smooth muscle in the cystic wall, confirming the diagnosis of esophageal duplication cyst.
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Patiño Mayer J, Bettolli M. Alimentary tract duplications in newborns and children: diagnostic aspects and the role of laparoscopic treatment. World J Gastroenterol 2014; 20:14263-71. [PMID: 25339813 PMCID: PMC4202355 DOI: 10.3748/wjg.v20.i39.14263] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/22/2014] [Accepted: 06/14/2014] [Indexed: 02/06/2023] Open
Abstract
Alimentary tract duplications are rare congenital lesions normally diagnosed in newborns and children that can occur anywhere from the mouth to the anus and have a reported incidence of approximately 1 in 4500 life births. Symptoms and clinical presentation vary greatly. The presentation varies according to age and location. The treatment finally is surgical; total resection when possible should be the aim of the intervention. In pediatric surgery minimally invasive surgical procedures became more and more important over the last decades. In consequence the operative procedure on alimentary tract duplications changed in this manner. We review on case reports and clinical reports on minimally invasive surgery in the treatment of alimentary tract duplications, determine the importance of minimally invasive techniques in the treatment of this rare entity and rule out that further studies in the field should be performed.
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Castelijns PSS, Woensdregt K, Hoevenaars B, Nieuwenhuijzen GAP. Intra-abdominal esophageal duplication cyst: A case report and review of the literature. World J Gastrointest Surg 2014; 6:112-116. [PMID: 24976905 PMCID: PMC4073222 DOI: 10.4240/wjgs.v6.i6.112] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 04/17/2014] [Accepted: 06/11/2014] [Indexed: 02/06/2023] Open
Abstract
Intra-abdominal esophageal duplications are rare entities in adults. They are mostly asymptomatic, but since they can lead to complications surgical excision is advised for all duplication cysts. We present a case of a 20-year-old male with colic-like abdominal pain, mimicking symptoms of cholecystolithiasis. However after cholecystectomy the symptoms were still present. A computed tomography-scan of the abdomen and an endoscopic ultrasound revealed a cyst of the esophagus of 3.0 cm × 2.3 cm in size. Diagnostic laparoscopy was planned, during which we observed a para-esophageal cyst at the gastro-esophageal junction. Laparoscopic excision of this cyst was performed. Pathophysiological examination revealed an esophageal duplication cyst. We report a rare case of a symptomatic intra-abdominal esophageal duplication cyst in an adult. One must consider this diagnosis when more common diagnoses to account for the patient’s symptoms are excluded. Removal of duplication cysts can be done laparoscopically.
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