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1
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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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2
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Zhang ZM, Kong S, Gao XX, Jia XH, Zheng CN. Colonic tubular duplication combined with congenital megacolon: A case report. World J Clin Cases 2022; 10:12768-12774. [PMID: 36579111 PMCID: PMC9791510 DOI: 10.12998/wjcc.v10.i34.12768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/21/2022] [Accepted: 11/11/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Colonic duplication refers to a spherical or tubular cavity which shows similar properties with the native colon and is attached to the mesenteric side of the alimentary tract. It is the rarest in alimentary tract duplications. Based upon anatomic feature, colonic duplications can be classified as spherical (cystic) or tubular, with the latter being less common (approximately 20%). Symptoms of colonic duplication are dependent on the duplication site and extent, and patient age, etc. Usually, patients with colonic duplication manifest typical intestinal obstruction, potentially accompanied by recurrent dark or bright red bloody stool, varying degrees of anemia-related symptoms, and body wasting.
CASE SUMMARY A young male patient was admitted to our hospital due to recurrent abdominal pain. No definite diagnosis was achieved by computed tomography (CT) or electronic colonoscopy, and the bowel preparation efficacy was suboptimal. Hirschsprung disease was suspected, and thus laparoscopic exploration was performed. An approximately 60-cm-long inverted duplicated colon with severe edema and dilation was identified. It originated from the mesenteric side of the transverse colon and ended in the terminal part of the descending colon with a blind end. The parallel native colon had a thickened colonic wall, became stiff, and was poor in peristalsis. The patient then underwent subtotal colectomy and was discharged 7 d after the surgery. From 3 mo post-surgery to date, the patient had regular bowel movement once daily and a steady increase in body weight.
CONCLUSION Tubular colonic duplication is a rare type of alimentary tract duplication that can be detected by ultrasonography, CT, or magnetic resonance imaging based on the actual clinical situation. Surgical resection of aberrant colon (including the duplicated colonic segment and other potentially involved colonic segments) is the only approach to cure this medical condition.
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Affiliation(s)
- Zhe-Ming Zhang
- School of Clinical Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
| | - Shuai Kong
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
| | - Xin-Xin Gao
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
| | - Xiang-Hao Jia
- School of Clinical Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
| | - Chun-Ning Zheng
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
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3
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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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4
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Wu T, Liu Y, Bai L, Zhao C. Pyloric Obstruction Secondary to a Gastric Duplication Cyst. Indian J Pediatr 2021; 88:732-733. [PMID: 32671636 DOI: 10.1007/s12098-020-03450-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/08/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Tingting Wu
- Department of Functional Examination in Children, Lanzhou University Second Hospital, Lanzhou, China
| | - Yuqin Liu
- Department of Functional Examination in Children, Lanzhou University Second Hospital, Lanzhou, China
| | - Liangcai Bai
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Chengji Zhao
- Department of Pediatric Surgery, Lanzhou University Second Hospital, Lanzhou, China.
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5
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Rahul S, Keshri R, Prasad R, Chaubey D, Hasan Z, Kumar V, Thakur V, Yadav R, Kumar R, Bakhtiyar A. Duplications of the alimentary tract in infants and children. FORMOSAN JOURNAL OF SURGERY 2021. [DOI: 10.4103/fjs.fjs_137_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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Kaur R, Dalal U, Kaur A. Rectal duplication cyst: a rare surgical case in a child. ANZ J Surg 2020; 91:E415-E416. [PMID: 33227169 DOI: 10.1111/ans.16460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/24/2020] [Accepted: 10/28/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Usha Dalal
- Department of General Surgery, Government Medical College and Hospital, Chandigarh, India
| | - Arshpreet Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
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7
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Leader BA, Rutter MJ, Shott SR, Smith MM. Endoscopic Removal of a Cervical Esophageal Duplication Cyst. Laryngoscope 2019; 130:2053-2055. [PMID: 31603535 DOI: 10.1002/lary.28326] [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: 05/19/2019] [Revised: 08/08/2019] [Accepted: 09/03/2019] [Indexed: 11/07/2022]
Abstract
A 6-month-old female presented for 2 months of noisy breathing. Flexible laryngoscopy showed limited bilateral vocal fold abduction. Computed tomography revealed a non-enhancing 3.6 × 2.3 × 3.5 cystic prevertebral mass spanning C2-T. Using an endoscopic approach, the overlying mucosa was incised, and the cyst was freed and fully excised from the surrounding mucosa with blunt microlaryngeal instruments without complication. Three months postoperatively she had no respiratory issues and was eating well. Flexible laryngoscopy revealed bilateral vocal fold mobility. We propose that endoscopic removal of a cervical esophageal duplication cyst in selected cases is an alternative to open excision. Laryngoscope, 130:2053-2055, 2020.
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Affiliation(s)
- Brittany A Leader
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Michael J Rutter
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.,Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Sally R Shott
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.,Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Matthew M Smith
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.,Division of Pediatric Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
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8
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Feng Y, Ye JN, Chen CQ, Zhang XH. Gastric duplication 20 years after a partial distal gastrectomy: a case report and review of literature. Ther Clin Risk Manag 2019; 15:943-949. [PMID: 31551656 PMCID: PMC6677379 DOI: 10.2147/tcrm.s206061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/14/2019] [Indexed: 12/28/2022] Open
Abstract
Gastric duplications are the least common gastrointestinal duplications, especially in adults. Duplication cyst with an accessory pancreatic lobe is extremely rare and is even more uncommon in the setting of polysplenia. No gastric duplication after partial gastrectomy has been reported. We present a 41-year-old male diagnosed with gastric duplications with an accessory pancreatic lobe and polysplenia. Another characteristic of this case is partial gastrectomy 20 years ago without the discovery of duplication cysts. The gastric duplications, accessory pancreatic lobe and accessory spleen were successfully resected.
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Affiliation(s)
- Yun Feng
- The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Jin-Ning Ye
- The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Chuang-Qi Chen
- The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Xin-Hua Zhang
- The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
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9
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Abstract
Background and Objectives: Duplications of the alimentary tract are rare anomalies. We report our experience with foregut duplication cysts including their clinical presentation, diagnostic modalities, and surgical management. Methods: We report a 20-year retrospective review of all foregut duplication cysts managed at our institution. Results: Twelve patients with 13 foregut duplication cysts were identified. The ages of the children at the time of surgery ranged from infancy to adolescence, with a mean age of 7.2 years. Half of the patients presented with abdominal pain and vomiting, and the remaining either had respiratory distress or were asymptomatic. All resections were performed electively. Two of the 11 patients had other congenital anomalies, including a congenital pulmonary airway malformation and coarctation of the aorta. One patient had prenatal diagnosis by ultrasonography. Nine patients underwent complete successful excision with no complications. Three patients whose symptoms resolved during hospitalization remained under observation because of parental preference. Conclusions: Foregut malformation in children may present with a variety of symptoms or can be found incidentally. The decision and timing of surgery is based on the clinical presentation. Surgical intervention in asymptomatic patients should be based on a thorough discussion with the parents.
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Affiliation(s)
| | | | - Shilpa Sood
- Department of Pediatrics, Division of Gastroenterology
| | - Natasha Bamji
- Department of Pediatrics, Division of Gastroenterology
| | | | - Gustavo Stringel
- Department of Surgery, Division of Pediatric Surgery, NY Medical College, Maria Fareri Children's Hospital, Valhalla, New York
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10
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Jack MW, Burgess D, Griffin A. Non-communicating gastric duplication cyst in a 10-week-old Labrador Retriever puppy. Aust Vet J 2016; 94:166-170. [DOI: 10.1111/avj.12427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 07/11/2015] [Accepted: 08/09/2015] [Indexed: 12/21/2022]
Affiliation(s)
- MW Jack
- Queensland Veterinary Specialists; Stafford Heights; Queensland 4053 Australia
| | - D Burgess
- Queensland Veterinary Specialists; Stafford Heights; Queensland 4053 Australia
| | - A Griffin
- Queensland Veterinary Specialists; Stafford Heights; Queensland 4053 Australia
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11
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Sharma S, Yadav AK, Mandal AK, Zaheer S, Yadav DK, Samie A. Enteric Duplication Cysts in Children: A Clinicopathological Dilemma. J Clin Diagn Res 2015; 9:EC08-11. [PMID: 26435952 DOI: 10.7860/jcdr/2015/12929.6381] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 06/12/2015] [Indexed: 12/15/2022]
Abstract
AIM Enteric duplication cysts are rare and uncommon congenital malformations formed during the embryonic period of the development of human digestive system and are mainly encountered during infancy or early childhood, but seldom in adults. The clinical presentation is extremely variable depending upon its size, location and type. We present six cases of enteric duplication cysts with diverse clinico-pathological features. MATERIALS AND METHODS This study was carried out in the Department of Pathology and Department of Paediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India for a period of 2 years (January 2013 - December 2014). We retrospectively analyzed six patients of enteric duplication cysts based on data obtained, which consisted of patient's age, sex, clinical presentation, radiological features, operative findings and histopathology report. The data collected was analyzed by descriptive statistics. RESULTS Six children between age range of 3 days to 10 years had enteric duplication cysts. Two had ileal and one each were of pyloroduodenal, colonic and rectal duplication cyst. In one patient a presumptive diagnosis of enteric duplication cyst was made. Radiology played an important contributory role in diagnosis of these cysts in all the patients but histopathology proved to be gold standard for its confirmation. All these patients were managed by surgical excision. The postoperative and follow up period in all the cases was uneventful. CONCLUSION It is important to be aware and make a definitive diagnosis of this rare congenital anomaly as they can present in various clinical forms and can cause significant morbidity and even mortality if left untreated by causing life threatening complications.
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Affiliation(s)
- Sonam Sharma
- Senior Resident, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Amit K Yadav
- Assistant Professor, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Ashish K Mandal
- Director Professor & Head, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Sufian Zaheer
- Assistant Professor, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Devendra K Yadav
- Assistant Professor, Department of Paediatric Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Amat Samie
- Senior Resident, Department of Paediatric Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
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12
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Geng YH, Wang CX, Li JT, Chen QY, Li XZ, Pan H. Gastric foregut cystic developmental malformation: case series and literature review. World J Gastroenterol 2015; 21:432-438. [PMID: 25593458 PMCID: PMC4292274 DOI: 10.3748/wjg.v21.i2.432] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 09/04/2014] [Accepted: 10/21/2014] [Indexed: 02/06/2023] Open
Abstract
Foregut cystic developmental malformation (FCDM) is a very rare lesion of the alimentary tract, especially in the stomach. We discuss the concepts of gastric duplication cyst, bronchogenic cysts, and FCDM. Nomenclature has been inconsistent and confusing, but, by some definitions, gastric duplication cysts involve gastric mucosa and submucosal glands, bronchogenic cysts involve respiratory mucosa with underlying cartilage and glands, and FCDM lacks gastric mucosa or underlying glands or cartilage but has pseudostratified ciliated columnar epithelium (PCCE). We searched our departmental case files from the past 15 years and identified 12 cases of FCDM in the alimentary tract. We summarize the features of these 12 cases including a report in detail on a 52-year-old man with a submucosal cyst lined with simple PCCE and irregular and stratified circular muscle layers that merged with gastric smooth muscle bundles near the lesser curvature of the gastric cardia. A literature review of cases with this histology yielded 25 cases. We propose the term gastric-FCDM for such cases. Our own series of 12 cases confirms that preoperative recognition of the entity is infrequent and problematic. The rarity of this developmental disorder, as well as a lack of understanding of its embryologic origins, may contribute to missing the diagnosis. Not appreciating the diagnosis preoperatively can lead to an inappropriate surgical approach. In contrast, presurgical recognition of the entity will contribute to a good outcome and reduced risk of complications.
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13
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Trainavicius K, Gurskas P, Povilavicius J. Duplication cyst of the pylorus: a case report. J Med Case Rep 2013; 7:175. [PMID: 23829942 PMCID: PMC3707747 DOI: 10.1186/1752-1947-7-175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 05/23/2013] [Indexed: 01/15/2023] Open
Abstract
Introduction Pyloric duplication is an extremely rare gastrointestinal tract malformation in neonates. This is the first case report of pyloric duplication in our country (Lithuania). Case presentation We report the case of a 2-day-old Lithuanian girl who suffered from pyloric duplication mimicking an alternative common bile duct cyst or other intra-abdominal organs cysts. A laparotomy was performed and the cystic formation of the pyloric area was successfully resected. The postoperative course was uneventful. Conclusions There are only a few reports describing abdominal masses caused by pyloric duplication mimicking common bile duct cyst or other intra-abdominal organs cysts. Therefore thorough clinical and instrumental examination is needed to determine the most accurate diagnosis that allows one to choose the right treatment.
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Affiliation(s)
- Kestutis Trainavicius
- Children's Surgery Centre, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Santariskiu Str, 7, LT 08406, Vilnius, Lithuania.
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14
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Christians KK, Pappas S, Pilgrim C, Tsai S, Quebbeman E. Duplicate pancreas meets gastric duplication cyst: A tale of two anomalies. Int J Surg Case Rep 2013; 4:735-9. [PMID: 23827696 PMCID: PMC3710888 DOI: 10.1016/j.ijscr.2013.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/06/2013] [Accepted: 05/12/2013] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Congenital anomalies are a rare cause of pancreatitis in adults. Gastric duplications are the least common duplication of the gastrointestinal tract and are even more uncommon in the setting of a duplicate pancreas. PRESENTATION OF CASE This manuscript contains a case report and review of the literature of an adult who presented with recurrent pancreatitis and was found to have a gastric duplication cyst that communicated with a duplicate pancreas. The study aim is to alert practitioners to the duplicate anomaly and recommend appropriate therapy. DISCUSSION Combined gastric and pancreatic duplications usually occur in young females with nonspecific, recurrent abdominal pain. This combined duplication can result in pancreatitis when the gastric duplication is contiguous with the stomach. Heightened awareness of the condition, appropriate diagnostics with accurate interpretation and a minimalist approach to resection are warranted. CONCLUSION Recurrent abdominal pain and pancreatitis in young adults devoid of risk factors should lead to consideration of congenital anomalies. Not all cysts near the pancreas and stomach are pseudocysts. ECRP and abdominal CT/MRI provide critical diagnostic information. This dual anomaly is best treated by simple excision of the gastric duplication and heterotopic pancreas.
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15
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Kashiwagi Y, Suzuki S, Watanabe K, Nishimata S, Kawashima H, Takekuma K, Hoshika A. Sudden unexpected death associated with ileocecal duplication cyst and clinical review. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2010; 4:25-8. [PMID: 23761993 PMCID: PMC3667037 DOI: 10.4137/cmped.s4850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Duplications of the alimentary tract are very rare. A one-month-old female presented with symptoms of anorexia, vomiting and continuous watery diarrhea. The plain abdominal radiograph showed thickened intestinal wall and signs of small bowel obstruction. The fevers, vomiting, and continuous wartery diarrhea persisted despite antibiotics, and worsened. The patient failed to respond to medical managements, 27 hours after admission, the patient died due to multiple organ failures. The autopsy was performed, small bowel obstruction due to an ileocecal duplication cyst (3 × 3 cm) was recognized. The ileocecal duplication cyst was attached to the ileum which was changed edematous and necrotic. This potential diagnosis should be borne in mind for a patient who complains of abdominal symptoms with an unknown cause, and duplication cyst should be recognized as a fatal cause in infant.
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Affiliation(s)
- Y Kashiwagi
- Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
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16
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Laparoscopic enucleation of a gastroenteric duplication cyst arising in a pancreatic tail that did not communicate with the pancreatic duct: report of a case. Surg Today 2010; 40:281-4. [PMID: 20180086 DOI: 10.1007/s00595-008-4051-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 09/30/2008] [Indexed: 01/11/2023]
Abstract
Gastroenteric duplication rarely occurs in locations such as the pancreas. We report a case of gastroenteric duplication of the pancreatic tail, which was noncontiguous with the stomach and had no communication with the pancreatic duct, in a 3-year-old girl. The cyst was enucleated by laparoscopy, without the need for pancreatic resection. The optimal treatment procedures vary considerably, depending on where the gastroenteric duplication is located in the pancreas and, most importantly, whether there is communication with the pancreatic duct.
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17
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Master V, Woods RH, Morris LL, Freeman J. Gastric duplication cyst causing gastric outlet obstruction. Pediatr Radiol 2004; 34:574-6. [PMID: 15205841 DOI: 10.1007/s00247-004-1146-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2003] [Revised: 10/01/2003] [Accepted: 12/29/2003] [Indexed: 01/07/2023]
Abstract
We report a rare case of gastric outlet obstruction in a newborn infant caused by a gastric duplication cyst. Ultrasound provided a non-invasive and conclusive diagnostic technique, which should be used as a baseline investigation for cases of suspected gastric outlet obstruction.
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Affiliation(s)
- Vahid Master
- Adelaide Women's and Children's Hospital, 72 King William Road, North Adelaide SA 5006, Australia.
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18
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Webster J, Terry S, Humphrey D, Khan SA. Anorexia and pancreatitis associated with a gastric duplication cyst of the pancreas. Surgery 2001; 129:375-6. [PMID: 11231468 DOI: 10.1067/msy.2001.106427] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- J Webster
- Departments of Surgery and Pathology, SUNY Health Science Center at Syracuse, Syracuse, NY, USA
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19
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Fitzgerald JF, Troncone R, Harnsberger JK. Clinical quiz. Gastric duplication. J Pediatr Gastroenterol Nutr 2000; 31:553, 571. [PMID: 11144441 DOI: 10.1097/00005176-200011000-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Abstract
Gastric duplication cysts are uncommon congenital anomalies and are rarely diagnosed in adults. We present a unique case of a communicating type gastric duplication in a young woman with the multimodality imaging findings including barium examination, CT, and endoscopy. The morphological criteria for diagnosis of duplication cyst suggested pathogenetic mechanisms for its formation as well as clinical presentation. Associated pathologies are reviewed.
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Affiliation(s)
- G Blinder
- MAR Institute for Diagnostic Radiology, Jerusalem, Israel
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21
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Abstract
An 11-month-old girl had massive rectal bleeding. A midabdominal mass was palpated. Ultrasound scan showed a large cystic mass with diffusely echogenic contents; Tc-99M radionuclide scan confirmed a duplication. Exploratory surgery and pathology examination showed a gastric duplication with formation of a fistula into the transverse colon with a colonic ulcer and hemorrhage. This combination of findings is presented as a rare cause of lower gastrointestinal hemorrhage in infancy.
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Affiliation(s)
- V Mahnovski
- Division of Anatomic Pathology, Childrens Hospital Los Angeles, CA 90027, USA
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Stringer MD, Spitz L, Abel R, Kiely E, Drake DP, Agrawal M, Stark Y, Brereton RJ. Management of alimentary tract duplication in children. Br J Surg 1995; 82:74-8. [PMID: 7881964 DOI: 10.1002/bjs.1800820126] [Citation(s) in RCA: 107] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Duplication of the alimentary tract is rare but potentially dangerous. Five of 72 children with alimentary tract duplication treated between 1973 and 1992 died from postoperative complications; a further ten required more than one operation. Ileal duplications were the commonest, occurring in 16 patients (22 per cent). Thoracoabdominal duplications were the most complicated and responsible for much of the overall morbidity and mortality. Surgical complications were related to the size and location of the duplication, communication with the gastrointestinal tract or vertebral canal, presence of heterotopic gastric mucosa and involvement of mesenteric vessels. Complete excision of the duplication should be possible in most cases.
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Affiliation(s)
- M D Stringer
- Department of Paediatric Surgery, Hospital for Sick Children, London, UK
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Ng KY, Desmond PV, Collier N. Relapsing pancreatitis due to juxta-pancreatic duodenal duplication cyst with pancreatic ductal communication. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1993; 63:224-9. [PMID: 8311801 DOI: 10.1111/j.1445-2197.1993.tb00524.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 21 year old patient first presented with acute pancreatitis in infancy, followed by subsequent episodes of relapsing pancreatitis in childhood. The cause of the pancreatitis defied diagnosis, despite two laparotomies in infancy and childhood, until twenty years later when a juxta-pancreatic duodenal duplication--a rare congenital lesion--was finally discovered. The duplication communicated with the main pancreatic duct via a long, aberrant duct, resulting in the relapsing pancreatitis. Abdominal ultrasonography and computerized tomography scan, and endoscopic retrograde cholangiopancreaticogram were useful in demonstrating the lesion. Surgical excision of part of the cyst, with marsupialization of the remaining structure to the stomach, abolished further symptoms and recurrence of pancreatitis.
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Affiliation(s)
- K Y Ng
- Department of Gastroenterology, St Vincent's Hospital, Victoria, Australia
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Abstract
A 4-month-old girl presented with intermittent left upper quadrant abdominal pain and was found to have an ectopic cystic gastric-like duplication attached to the tail of the pancreas. The literature, pathology, clinical features, diagnosis, and treatment are discussed.
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Affiliation(s)
- M Wold
- Division of Pediatric Surgery, Albany Medical College, NY
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Black PR, Welch KJ, Eraklis AJ. Juxtapancreatic intestinal duplications with pancreatic ductal communication: a cause of pancreatitis and recurrent abdominal pain in childhood. J Pediatr Surg 1986; 21:257-61. [PMID: 3958888 DOI: 10.1016/s0022-3468(86)80849-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Pancreatic duplications with ductal communications should be included in the differential diagnosis of any child presenting with recurrent abdominal pain of unknown etiology and should be considered as a possible cause of pancreatitis in childhood. Such duplications most likely arise from nonregressing diverticula of the pancreatic bud during embryologic development. Their clinical presentation is unique from other duplications because of their anatomic association with the pancreatic duct. Pain and weight loss are the major presenting complaints, although many patients have nausea and vomiting. Serum chemistries, in particular the serum amylase, are usually normal and are of little help in the differential diagnosis. Radiographic evaluation has not been particularly helpful in the past. ERCP, ultrasonic examination, and CT scan show great promise, however. Operative intervention should be tailored for the individual patient. The operation performed will depend upon operative findings. Intraoperative pancreatograms or cystograms are very helpful in differentiating these cysts from others at the time of operation. Pathologically, most of the duplications have a thickened muscular coat that usually has some evidence of inflammation. They are usually lined with gastric mucosa. Except in the most severe cases, the pancreas is histologically normal, suggesting that most of the pain experienced by these patients is secondary to inflammation within the duplication. The inflammatory response may completely destroy the mucosal lining and cause fibrosis within the muscular coat of the duplication. In those instances, these lesions cannot be differentiated from pancreatic pseudocyst. This may account for some of the "idiopathic" pseudocysts reported in the literature.
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 28-1985. Recurrent abdominal pain and an epigastric mass in a 21-year-old woman. N Engl J Med 1985; 313:104-10. [PMID: 4000233 DOI: 10.1056/nejm198507113130208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
A case of an ectopic gastric duplication cyst that appeared to arise from the pancreas in a 10-week-old infant with a superficial mass in the left upper quadrant is reported. Preoperative ultrasound showed a cystic lesion with an inner echogenic layer (mucosa) and an outer anechoic rim (muscle). Technetium scan demonstrated that there was a gastric-type mucosa in the cyst. It is suggested that the ultrasound findings are specific for a gastric duplication cyst and that ultrasound and technetium scan alone will adequately characterize these lesions preoperatively.
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28
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Abstract
A case of gastric duplication in an infant is reported. Preoperative ultrasound demonstrated a cystic mass lesion with a thin inner echogenic (mucosa) and a wider outer hypoechoic rim (muscle layer). These findings correlated well with the resected specimen.
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29
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Schwartz DL, So HB, Becker JM, Schneider KM. An ectopic gastric duplication arising from the pancreas and presenting with a pneumoperitoneum. J Pediatr Surg 1979; 14:187-8. [PMID: 458544 DOI: 10.1016/0022-3468(79)90018-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This case report describes a large gastric duplication, which had no attachment to the stomach, and it was found in the pancreas. The second unusual feature of this duplication was that it had eroded into the splenic flexure of the colon, resulting in a large pneumoperitoneum.
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30
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Abstract
Vomiting and failure to thrive were the presenting complaints of a patient with gastric duplication. The case is presented and features of gastric duplication are summarized with other cases reported in the literature.
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