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An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time. Surg Case Rep 2021; 7:258. [PMID: 34914020 PMCID: PMC8677869 DOI: 10.1186/s40792-021-01337-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background Adult cases of retroperitoneal isolated enteric duplication cyst (IEDC) are rare, with only 17 case reports in the relevant literature. We herein present a case, which was characterized by changes in intra-cystic density on computed tomography (CT), which was safely resected by laparoscopic surgery. Case presentation The patient was a 60-year-old male who received abdominal CT to investigate the cause of increased serum CA19-9 levels. CT revealed a unilocular cystic mass located in the lower right retroperitoneum. The size increased from 5 to 10 cm in three and a half years and the CT value decreased from 101 Hounsfield Units (HU) to 20 HU. We performed laparoscopic surgical resection, because the possibility that the enlargement of the lesion represented malignant transformation could not be denied. The large cystic mass firmly adhered to the appendix and its mesentery via the retroperitoneum, the appendix was resected en bloc with the cystic lesion. Microscopically, it had no communication with the appendix, and had an intestinal wall structure of muscularis mucosae and muscularis propria. The final pathological diagnosis was IEDC in the retroperitoneal space. There was no histological evidence of malignancy. Conclusion When we encounter a retroperitoneal cystic lesion, we should consider the possibility of malignancy to determine the treatment strategy and perform a careful operation without breaking the cyst wall, irrespective of the preoperative diagnosis.
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Banerjee R, Singh G, Aggarwal SK. A rare presentation of Y-duplication of the pancreatic tail with enteric duplication cyst as intussusception in a child: A case report. Int J Surg Case Rep 2020; 78:96-98. [PMID: 33316612 PMCID: PMC7744632 DOI: 10.1016/j.ijscr.2020.11.131] [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: 11/04/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/02/2022] Open
Abstract
Duplication cysts can occur anywhere in the gastrointestinal tract but duplication cyst within the pancreas is rare. The most common presentation reported is abdominal pain secondary to pancreatitis. The present case presented with abdominal pain, non-bilious vomiting and ill-defined lump in the left lumbar region. USG showed a target sign and intussusception was suspected. At operation, there was a thick-walled cyst in relation to tail of pancreas, covered with necrotic omentum. Histology confirmed enteric gastric duplication.
We report a case of a 2-year-old girl who presented to us with complaints of pain abdomen and non-bilious vomiting. USG was suggestive of intussusception with necrotic bowel and free fluid in the left lumbar region. Operative findings were of enteric duplication cyst of the pancreas which was later confirmed on histopathology. Enteric duplication cysts can occur anywhere in the gastrointestinal tract but duplication cyst within the pancreas is rare. The most common presentation in other reported cases is pain abdomen due to pancreatitis but in our case, we had findings of intussusception. Children usually present with a severe complication like perforation of duplication cyst as in our case. Excision of the cyst and the duplicated pancreatic tail is the mainstay of treatment.
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Affiliation(s)
- Rupa Banerjee
- Department of Pediatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Gaurav Singh
- Department of Pediatric Surgery, Sir Ganga Ram Hospital, New Delhi, India.
| | - Satish K Aggarwal
- Department of Pediatric Surgery, Sir Ganga Ram Hospital, New Delhi, India.
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Dilawar B, Hamid LR, Pirzada AN, Arshad M. Duodenal duplication cyst presenting as bilious vomiting in a neonate. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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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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Dipasquale V, Barraco P, Faraci S, Balassone V, De Angelis P, Di Matteo FM, Dall'Oglio L, Romano C. Duodenal Duplication Cysts in Children: Clinical Features and Current Treatment Choices. Biomed Hub 2020; 5:152-164. [PMID: 32884929 DOI: 10.1159/000508489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/04/2020] [Indexed: 12/26/2022] Open
Abstract
Background Duodenal duplication cysts are rare gastrointestinal tract malformations. Most patients experience symptom onset in the first decade of life. This review aims to examine clinical presentation, management strategies and outcomes of duodenal duplication cysts in childhood. Methods A Pubmed/Medline (http://www.ncbi.nlm.nih.gov/pubmed/) search in October 2019 for articles published since 1999 using the keywords "duodenal duplication cyst," "child" and "newborn" was carried out. Clinical symptoms, complications, diagnostic examinations, treatment options and outcomes were analyzed and tabulated. Results There were 41 citations in the literature providing adequate descriptions of 45 cases of duodenal duplication cysts. The age of presentation ranged from newborn to 18 years. The median interval between initial presentation and definitive diagnosis and treatment was 17 months (range: 2 months to 12 years). Overall, 67% of cases presented with abdominal pain, and 43% were complicated with pancreatitis. Different surgical and endoscopic therapeutic strategies were reported. Conclusions Duodenal duplication cysts may be associated with life-threatening complications and/or recurrent symptoms, impairing quality of life. Early recognition of patients who demonstrate suggestive signs and symptoms is important to ensure success of treatment. This review may be useful to highlight the main diagnostic aspects and limit the risk of a delayed diagnosis.
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Affiliation(s)
- Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood G. Barresi, University Hospital of Messina, Messina, Italy
| | - Paolo Barraco
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood G. Barresi, University Hospital of Messina, Messina, Italy
| | - Simona Faraci
- Digestive Endoscopy and Surgery Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | - Valerio Balassone
- Digestive Endoscopy and Surgery Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | - Paola De Angelis
- Digestive Endoscopy and Surgery Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | | | - Luigi Dall'Oglio
- Digestive Endoscopy and Surgery Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood G. Barresi, University Hospital of Messina, Messina, Italy
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Fazal FA, Okiro P. Retroperitoneal isolated enteric duplication cyst. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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A case of completely isolated advanced enteric duplication cyst cancer performed partial pancreatectomy. Int J Surg Case Rep 2018; 54:83-86. [PMID: 30553095 PMCID: PMC6297057 DOI: 10.1016/j.ijscr.2018.11.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/22/2018] [Accepted: 11/25/2018] [Indexed: 02/07/2023] Open
Abstract
Duplication cysts commonly have connection to the gastrointestinal tract but the cysts are rarely isolated from gastrointestinal tract. Malignant transformation in isolated duplication cysts is extremely rare. This case of advanced cancer with the isolated intestinal duplication cyst was second reported worldwide. The preoperative diagnosis was suspect of mucinous cystic neoplasm arising from pancreas head and partial pancreatectomy was performed. However, in the pathological findings, this cyst diagnosed advanced enteric duplication cyst cancer and not originated from pancreas.
Introduction Enteric duplication cysts are rare and, in addition, isolated enteric duplication cysts are lower morbidity prevalence rate. These cysts lack a connection to the gastrointestinal tract or the adjacent mesenteric vasculature and have only been reported in 10 case reports. In these reports, only two reports were cases with malignant transformation. Our case was a report for the advanced cancer of the isolated enteric duplication cyst. Case presentation The patient was a 43 year-old woman with slightly abdominal pain and mass formation. The abdominal contrast-enhanced computed tomography showed 130 × 100 × 90 mm huge cystic mass existed in right upper peritoneal cavity. The cystic mass had thickened wall and many enhanced nodules. As these imaging findings suggested a tumor originated from pancreas and the preoperative diagnose was suspect of mucinous cystic neoplasm. In operative findings, the tumor originated from pancreatic head and did not attach to gastrointestinal tract. Final pathology indicated the cyst was an isolated advanced enteric duplication cyst cancer and not originated from pancreas. Conclusion We experienced an extremely rare case of completely isolated advanced enteric duplication cyst cancer. Unique to this case, the preoperative diagnosis was suspect of mucinous cystic neoplasm arising from pancreas head and partial pancreatectomy was performed. However, in the pathological findings, this cyst diagnosed advanced enteric duplication cyst cancer.
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Ogawa K, Kanamori Y, Watanabe T, Tomonaga K, Kutsukake M, Goto M, Ohno M, Tahara K, Hishiki T, Fujino A. Acute pancreatitis caused by a duodenal duplication cyst covering the ampulla of Vater. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2018.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Sasaki N, Okamura M, Kanto S, Tatsumi K, Yasuda S, Kawabe A. Laparoscopic excision of a retroperitoneal completely isolated enteric duplication cyst in an adult male: A case report and review of literature. Int J Surg Case Rep 2018; 46:1-5. [PMID: 29626802 PMCID: PMC6000737 DOI: 10.1016/j.ijscr.2018.03.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 03/23/2018] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Duplication cysts are very rare congenital malformations in adults. They are lined by gastrointestinal mucosa, connect to the digestive tract, and share smooth muscular layers and a common blood supply. In rare cases, duplication cysts are completely isolated from the digestive tract and have a proper blood supply. Completely isolated duplication cysts in the retroperitoneum are unusual so it is hard to diagnose them without a surgical resection. PRESENTATION OF CASE A 19-year-old male presented at our emergency department with sharp abdominal pain. Contrast-enhanced computed tomography detected a 5-cm multilocular cystic mass located in the retroperitoneum, caudal to the pancreatic body. The cystic mass was safely resected with laparoscopic surgery without any complication. The final pathological diagnosis was an epithelium-lined duplication cyst in the retroperitoneal space. There was no evidence of malignancy in the duplication cyst. Intracystic bleeding was assumed to be the cause of the abdominal pain. DISCUSSION The most common differential diagnoses of retroperitoneal cystic masses are pseudocysts related to pancreatitis, cysts from surrounding structures, and neoplasms. In this case, the cystic mass was diagnosed as completely isolated duplication cyst after surgical resection. It is very rarely observed in adults, but it should be listed on differential diagnoses because it has some possibility of malignancy. CONCLUSION A completely isolated duplication cyst is very rare but noteworthy because there is some possibility of malignancy, ulcerative bleeding, and perforation. A surgical resection is recommended for diagnostic treatment. Laparoscopic surgery is favorable for intraoperative inspection and it is minimally invasive.
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Affiliation(s)
- Naoya Sasaki
- Department of Surgery, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone-shi, Shiga Prefecture, Japan.
| | - Miru Okamura
- Department of Surgery, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone-shi, Shiga Prefecture, Japan.
| | - Satoshi Kanto
- Department of Surgery, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone-shi, Shiga Prefecture, Japan.
| | - Kentaro Tatsumi
- Department of Surgery, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone-shi, Shiga Prefecture, Japan.
| | - Seiichi Yasuda
- Department of Surgery, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone-shi, Shiga Prefecture, Japan.
| | - Atsushi Kawabe
- Department of Surgery, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone-shi, Shiga Prefecture, Japan.
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Weitman E, Al Diffalha S, Centeno B, Hodul P. An isolated intestinal duplication cyst masquerading as a mucinous cystic neoplasm of the pancreas: A case report and review of the literature. Int J Surg Case Rep 2017; 39:208-211. [PMID: 28854411 PMCID: PMC5575442 DOI: 10.1016/j.ijscr.2017.08.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 08/09/2017] [Accepted: 08/09/2017] [Indexed: 12/29/2022] Open
Abstract
Intestinal duplications cysts are rare congenital anomalies that can occur throughout the gastrointestinal tract. Isolated intestinal duplication cysts can present with vague abdominal complaints. Diagnosis can be challenging even with imaging. Our clinical workup was suggestive of a mucinous cystic neoplasm (MCN) of the pancreas. This represents the first reported case of an enteric duplication cyst that mimicked an MCN of the pancreas.
Introduction Enteric duplication cysts presenting in adulthood are rare. Isolated enteric duplication cysts, which lack a connection to the GI tract or the adjacent mesenteric vasculature, have only been cited in six previous case reports. Case presentation A 48-year-old female presented with a four-year history of intermittent nausea, vomiting and abdominal pain. Computed tomography (CT) scan of the abdomen revealed a 7 cm multi-lobular, calcified, cystic lesion intimately involved with the pancreas. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) was non-diagnostic; however, the cyst fluid Carcinoembryonic Antigen (CEA) level was significantly elevated leading to a presumed diagnosis of a mucinous cystic neoplasm (MCN) of the pancreas. Intraoperatively, the cystic mass was identified and notably did not have any true attachments to the neighboring pancreas, gastrointestinal tract or vasculature. Final pathology demonstrated an isolated small bowel duplication cyst. Discussion In this case a patient presented with a clinical picture consistent with an MCN of the pancreas. However, intraoperatively and on final pathology the mass was found to be an isolated enteric duplication cyst. This represents only the seventh such case report in an adult. Conclusion Although rare, isolated enteric duplication cysts can be considered in a patient presenting with chronic abdominal pain and an abdominal mass on imaging. In this case we demonstrate that an isolated enteric duplication cyst can clinically mimic an MCN of the pancreas.
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Affiliation(s)
- Daisuke Yoshikawa
- Department of Gastroenterology and Hepatology, Sasebo City General Hospital, Sasebo, Japan
| | - Takuji Yamao
- Department of Gastroenterology and Hepatology, Sasebo City General Hospital, Sasebo, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Siviero I, Forny DN, Méio IB, Penna CR, Ferrante SMR. Duodenal duplication, intestinal malrotation and volvulus: An unusual cause of intestinal obstruction. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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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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Shimoda Y, Okada S, Shimoyama Y, Kusano M, Yamada M. Maturity onset diabetes of the young 5 accompanied by duodenal cysts. J Diabetes 2016; 8:448-9. [PMID: 26676964 DOI: 10.1111/1753-0407.12367] [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] [Received: 10/09/2015] [Revised: 11/23/2015] [Accepted: 12/08/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yoko Shimoda
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Shuichi Okada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Yasuyuki Shimoyama
- Department of Endoscopy and Endoscopic Surgery, Gunma University Hospital, Gunma, Japan
| | - Motoyasu Kusano
- Department of Endoscopy and Endoscopic Surgery, Gunma University Hospital, Gunma, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan
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Imaging Findings of Duodenal Duplication Cyst Complicated with Duodenal Intussusception and Biliary Dilatation. Case Rep Radiol 2016; 2016:3069576. [PMID: 26989550 PMCID: PMC4773525 DOI: 10.1155/2016/3069576] [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: 10/25/2015] [Accepted: 01/27/2016] [Indexed: 12/18/2022] Open
Abstract
Duodenal duplication cyst is an extremely rare congenital anomaly usually diagnosed in childhood. However, it may remain asymptomatic for a long period. In adults it usually manifests with symptoms related to complications as pancreatitis, jaundice, or intussusception. We present the radiology findings of a patient with a duodenal intussusception secondary to a duplication cyst. The usefulness of the magnetic resonance (MR) in this case is highlighted.
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A large intrahepatic duodenal duplication cyst in a 3 year-old girl. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2015.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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17
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Surgical management of an intussuscepted duodenal duplication cyst in a pediatric patient with heterotaxy. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2015. [DOI: 10.1016/j.epsc.2015.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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18
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Zhu L, Lv Z, Liu J, Xu W. Choledochocele: A Case Report and Discussion of Diagnosis Criteria. European J Pediatr Surg Rep 2015; 3:85-9. [PMID: 26788455 PMCID: PMC4712052 DOI: 10.1055/s-0035-1563601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 07/03/2015] [Indexed: 02/06/2023] Open
Abstract
A 6-year-old girl presented with intermittent abdominal pain, without jaundice and a palpable mass in the epigastrium. Preoperative imaging and upper endoscopy suggested duodenal duplication. During surgery, the patient was diagnosed with a rare type of choledochal cyst—choledochocele (type 3b). The authors emphasize that, in children, choledochocele should be included in the differential diagnosis of cystic lesions located in the duodenal area and the head of the pancreas area, regardless of jaundice or abnormal liver function. Since mucosal histology showing duodenal mucosa did not match the final diagnosis, we suggest that three criteria should be met for the diagnosis of a choledochocele to be diagnosed: (1) a cyst protruding into the duodenal lumen; (2) filling with contrast during cholangiography and (3) a filling defect on X-ray barium meal.
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Affiliation(s)
- Linlin Zhu
- Department of Surgery, Children's Hospital of Shanghai Jiaotong University, Shanghai, China
| | - Zhibao Lv
- Department of Surgery, Children's Hospital of Shanghai Jiaotong University, Shanghai, China
| | - Jiangbin Liu
- Department of Surgery, Children's Hospital of Shanghai Jiaotong University, Shanghai, China
| | - Weijue Xu
- Department of Surgery, Children's Hospital of Shanghai Jiaotong University, Shanghai, China
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Zhu L, Lv Z, Liu J, Xu W. WITHDRAWN: Choledochocele: A Case Report and Discussion of Diagnosis Criterias. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2014. [DOI: 10.1016/j.epsc.2014.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Destruys L, Guinard-Samuel V, Peycelon M, Ducou Le Pointe H, Tounian P. [Duodenal duplication cyst causing acute obstructive pancreatitis in a young girl with Crohn disease]. Arch Pediatr 2014; 21:532-4. [PMID: 24709318 DOI: 10.1016/j.arcped.2014.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 02/20/2014] [Indexed: 11/27/2022]
Affiliation(s)
- L Destruys
- Service de nutrition et gastroentérologie pédiatriques, hôpital Armand-Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France
| | - V Guinard-Samuel
- Service de nutrition et gastroentérologie pédiatriques, hôpital Armand-Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France.
| | - M Peycelon
- Service de chirurgie viscérale néonatale et pédiatrique, hôpital Armand-Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France
| | - H Ducou Le Pointe
- Service de radiologie, hôpital Armand-Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France
| | - P Tounian
- Service de nutrition et gastroentérologie pédiatriques, hôpital Armand-Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France
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Law R, Topazian M. Diagnosis and treatment of choledochoceles. Clin Gastroenterol Hepatol 2014; 12:196-203. [PMID: 23660418 DOI: 10.1016/j.cgh.2013.04.037] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 04/15/2013] [Accepted: 04/16/2013] [Indexed: 02/07/2023]
Abstract
Choledochoceles are cystic dilatations of the intraduodenal portion of the common bile duct. Although often classified as Type III biliary cysts, choledochoceles have distinctive demographic and anatomic features and a lower risk of malignancy than other types of choledochal cysts. Type A choledochoceles are cystic dilatations of a segment of the intra-ampullary bile duct and are located proximal to the ampullary orifice. Type B choledochoceles are diverticula of the intra-ampullary common channel and are located distal to the ampullary orifice; they can be distinguished from duodenal duplication cysts both anatomically and histologically. Both types of choledochocele may present with pancreatitis, biliary obstruction, or nonspecific gastrointestinal symptoms. Cross-sectional imaging, endoscopic ultrasound, and endoscopic retrograde cholangiopancreatography are useful for diagnosis. Choledochoceles may be drained or resected endoscopically. Surveillance for dysplasia should be considered for lesions that are not resected.
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Affiliation(s)
- Ryan Law
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Mark Topazian
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
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22
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Tsai SD, Sopha SC, Fishman EK. Isolated duodenal duplication cyst presenting as a complex solid and cystic mass in the upper abdomen. J Radiol Case Rep 2014; 7:32-7. [PMID: 24421928 DOI: 10.3941/jrcr.v7i11.1785] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Duodenal duplication cysts are a rare subtype of gastrointestinal duplications cysts. Approximately 5% of gastrointestinal duplication cysts occur in the duodenum. An 18-year-old woman presented with epigastric pain and a subjective abdominal bulge. A computed tomography scan was subsequently performed and showed a solid and cystic mass with wall calcifications in the lesser sac of the upper abdomen. A duodenal duplication cyst was found unexpectedly on histopathologic analysis. This was also an unusual case as there was no evidence of malignancy. Four years after surgery, the patient remains asymptomatic. We present a brief literature review on duodenal duplication cysts and discuss its differential diagnosis.
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Affiliation(s)
- Salina D Tsai
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Sabrina C Sopha
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Elliot K Fishman
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Komori K, Hirobe S, Toma M, Nishimura G, Fukuzawa R. A gastric duplication cyst of the pancreas associated with a bifid tail causing pancreatitis. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Antaki N, Abboud D, Lemmers A, Antaki F, Devière J. Acute recurrent pancreatitis secondary to the rare association of a duodenal duplication cyst and a pancreas divisum. Clin Res Hepatol Gastroenterol 2013; 37:e32-6. [PMID: 22749085 DOI: 10.1016/j.clinre.2012.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Revised: 04/27/2012] [Accepted: 05/15/2012] [Indexed: 02/04/2023]
Abstract
Duodenal duplication cysts are rare congenital anomalies that can cause acute pancreatitis. Pancreas divisum is also a congenital anomaly, often discovered incidentally, but is considered a possible cause of acute pancreatitis. We report the case of the combination of both anomalies causing recurrent episodes of acute pancreatitis in a young man. Endoscopic treatment by partial excision of the cyst with a polypectomy snare and sphincterotomy of the minor papilla was successful.
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Affiliation(s)
- Nabil Antaki
- Department of Gastroenterology, Saint-Louis Hospital, PO Box 6448, Aleppo, Syria.
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Chattopadhyay A, Mitra SK, Dutta S, Chakraborty H. Gastric, pancreatic, and ureteric duplication. J Indian Assoc Pediatr Surg 2011; 15:25-7. [PMID: 21180501 PMCID: PMC2998665 DOI: 10.4103/0971-9261.69138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We report a case of an 8-month-old, asymptomatic child who was incidentally detected to have two cystic structures in the abdomen. Surgical exploration revealed a gastric and pancreatic duplication cyst along with a blind-ending duplication of the right ureter. Excision of the duplications was relatively straightforward, and the child made an uneventful recovery. This constellation of duplications has not been reported before.
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Affiliation(s)
- Anindya Chattopadhyay
- Susruta Clinic and Research Institute for Advanced Medicine, JC-16 & 17, Salt Lake City, Kolkata - 700 098, India
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Emoto K, Mukai M, Kawachi S, Kitagawa Y, Sakamoto M. Duplication of the digestive organs in the retroperitoneum: a case report with reference to the importance of a standardized nomenclature and definition. Pathol Int 2011; 61:430-4. [PMID: 21707847 DOI: 10.1111/j.1440-1827.2011.02678.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Duplications of the digestive organs, especially in the retroperitoneum, are rare malformations. We present the case of a 20-year-old man who had recurrent abdominal pain because of a solid and cystic mass located in the retroperitoneum, posterior to the pancreatic body. Preoperative diagnosis was difficult and a resection was performed. Histopathologically, intestinal mucosa, respiratory mucosa, aberrant pancreatic tissue, smooth muscle coat, and an external fibrous capsule were found. The mass was diagnosed as a duplication of the digestive organs. Findings in the pancreatic tissue indicated chronic pancreatitis and mild atypia in the pancreatic duct epithelium. Currently, many terms are used to describe these series of malformations, including duplication, foregut cyst, gastrointestinal duplication cyst, and enteric duplication cyst. Consequently, diagnosis and investigation can be difficult. In the atlas produced by the Armed Forces Institute of Pathology, duplication is used as a standardized diagnostic nomenclature with subclassification according to the site, but this has not been uniformly accepted. In addition, there are cases whose origins are unclear, especially in the retroperitoneum. In this report, we propose that the term duplication should be uniformly used for all cases in the digestive organs, and that they may then be distinguished according to their mechanisms.
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Affiliation(s)
- Katsura Emoto
- Department of Pathology Division of Diagnostic Pathology Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Chen JJ, Lee HC, Yeung CY, Chan WT, Jiang CB, Sheu JC. Meta-analysis: the clinical features of the duodenal duplication cyst. J Pediatr Surg 2010; 45:1598-606. [PMID: 20713206 DOI: 10.1016/j.jpedsurg.2010.01.010] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2009] [Revised: 01/05/2010] [Accepted: 01/06/2010] [Indexed: 12/22/2022]
Abstract
BACKGROUND Duplication cyst of the duodenum is rare. This study describes a case of duodenal duplication and evaluates its clinical features through a literature review. METHODS A case of duodenal duplication is reported, and related articles published from 1999 to 2009 on PubMed were reviewed. Clinical manifestations, diagnostic examinations, and methods of management were analyzed. RESULTS Including this report, there had been 38 citations in literature that provide adequate descriptions of 47 cases of duodenal duplication cysts. Nineteen (40.4%) were discovered before 10 years of age, whereas 10 (21.3%) were found in the second decade. The remaining 18 patients (38.3%) were older than 20 years. The case number decreased as age increased. Overall, 80% of cases presented with abdominal pain, and 53% were complicated with pancreatitis. CONCLUSIONS The most common symptom in duodenal duplication cysts is abdominal pain with or without nausea or vomiting. The most common complication is pancreatitis. Differential diagnoses of pancreatitis, hepatitis, cholestasis, or intussusception should include duplication cyst of the duodenum.
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Affiliation(s)
- Jeng-Jung Chen
- Department of Pediatrics, Mackay Memorial Hospital, Taipei 10449, Taiwan
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Jung MK, Park SY, Jeon SW, Cho CM, Tak WY, Kweon YO, Kim GC, Bae HI. Duodenal duplication cysts of ampulla of vater containing stone. Gut Liver 2009; 3:356-9. [PMID: 20431777 PMCID: PMC2852724 DOI: 10.5009/gnl.2009.3.4.356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 09/01/2009] [Indexed: 11/04/2022] Open
Abstract
Duodenal duplication cysts are rare congenital malformations. Most symptomatic cases are diagnosed in children and usually present with obstructive findings or bleeding symptoms. Treatment traditionally involves surgical resection, which can be often difficult because of the close proximity of the cysts to the papilla and bilopancreatic confluence. Endoscopic therapy has been used as an alternative to open surgery in a few selected cases. We report a case with a duodenal duplication cyst containing a brown pigmented stone within the cystic lumen. He was visited because of sudden right upper quadrant abdominal pain. An abdominal computed tomography revealed the presence of a cyst with a stone, which was finally removed by endoscopic resection.
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Affiliation(s)
- Min Kyu Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
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Duodenal Duplication CYST Manifested by Obstructive Jaundice and Bowel Obstruction in a Young Man. POLISH JOURNAL OF SURGERY 2009. [DOI: 10.2478/v10035-009-0023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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30
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Stone-containing periampullary duodenal duplication cyst with aberrant pancreatic duct. J Pediatr Surg 2009; 44:e33-5. [PMID: 19159708 DOI: 10.1016/j.jpedsurg.2008.10.106] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Revised: 09/28/2008] [Accepted: 10/26/2008] [Indexed: 02/07/2023]
Abstract
This case report describes a unique variant of a duodenal duplication cyst in an 8-year-old boy who had recurrent episodes of upper abdominal pain. Imaging revealed a stone-containing cyst near the biliaropancreatic ducts and concomitant hydrops of the gallbladder. Open transduodenal marsupialization of the cyst and resection of the inflamed gallbladder were performed. Further episodes of pancreatitis did not occur for a follow-up of 2 years.
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Hishiki T, Saito T, Terui K, Mitsunaga T, Nakata M, Matsuura G, Yoshida H. A rare presentation in a case of gastric duplication cyst communicating to the pancreatic duct: coincidental detection during pyloromyotomy for hypertrophic pyloric stenosis. J Pediatr Surg 2008; 43:e1-3. [PMID: 18778980 DOI: 10.1016/j.jpedsurg.2008.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 04/03/2008] [Accepted: 04/04/2008] [Indexed: 01/15/2023]
Abstract
A rare case of gastric duplication of childhood is reported. A 1-month-old boy underwent pyloromyotomy for infantile hypertrophic pyloric stenosis. At laparotomy, a protruding lesion was identified in the anterior wall of the pylorus. The pylorus was hypertrophic as indicated preoperatively, and a normal pyloromyotomy was performed. Wedge biopsy of the protruding lesion revealed an intestinal structure, and gastric duplication was diagnosed. The child remained asymptomatic thereafter, but considering the risk of the duplication becoming symptomatic, a second laparotomy was performed at 1 year of age. The duplication cyst shared part of the wall with the pylorus, and the cyst was removed by cystectomy, leaving the pyloric muscle intact. The cyst was found to be communicating with the pancreatic duct. The child is doing well without any symptoms as of 18 months after second laparotomy. To the best of our knowledge, this is the youngest case of gastroduodenal duplication with pancreatic duct communication yet reported.
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Affiliation(s)
- Tomoro Hishiki
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan
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Hunter CJ, Connelly ME, Ghaffari N, Anselmo D, Gonzalez I, Shin C. Enteric duplication cysts of the pancreas: a report of two cases and review of the literature. Pediatr Surg Int 2008; 24:227-33. [PMID: 18060413 DOI: 10.1007/s00383-007-2084-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2007] [Indexed: 01/15/2023]
Abstract
Enteric duplication cysts are rare congenital malformations that are most commonly diagnosed in children. Enteric duplications associated with the pancreas are especially uncommon, and may present with specific clinical findings such as severe pancreatitis. These cysts often pose unique surgical challenges. In addition, the diagnosis of pancreatic duplication cysts is often difficult, and may be confused with pancreatic pseudocysts or neoplasms. Herein we report two cases of pancreatic duplication cysts, and present a complete tabulation of all case reports of pancreatic-associated duplication cysts reported in the English literature. We conclude that pancreatic duplication cysts are a rare entity, most commonly found to occur in infants and children. We further find that although severe complications may arise as a result of their presentation and treatment, the rate of post-operative complications in patients between 3 and 21 years of age is extremely low, with the highest complication rate occurring in a bimodal distribution (<3-years and >21-years of age). Despite complications in the youngest and older patient populations, surgical excision remains the mainstay of therapy for pancreatic duplication cysts in all age groups.
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Affiliation(s)
- Catherine J Hunter
- Department of Surgery, Childrens Hospital Los Angeles, 4650 Sunset Blvd., Mail Stop #35, Los Angeles, CA 90027, USA.
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Antaki F, Tringali A, Deprez P, Kwan V, Costamagna G, Le Moine O, Delhaye M, Cremer M, Devière J. A case series of symptomatic intraluminal duodenal duplication cysts: presentation, endoscopic therapy, and long-term outcome (with video). Gastrointest Endosc 2008; 67:163-8. [PMID: 18155438 DOI: 10.1016/j.gie.2007.08.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2007] [Accepted: 08/02/2007] [Indexed: 02/08/2023]
Abstract
BACKGROUND Duodenal duplication cysts are rare congenital anomalies. Symptomatic cases have classically been treated by surgical resection, which can be complex because of the close proximity of the cysts to the papilla. OBJECTIVE To describe a series of 8 patients with symptomatic duodenal duplication cysts who were treated endoscopically, with a special focus on the long-term outcome. DESIGN Retrospective case series. SETTING Three tertiary-care European academic hospitals. PATIENTS Eight patients, age 8 to 72 years, were treated endoscopically for symptomatic intraluminal duodenal duplication cysts between 1981 and 2006. Seven patients presented with acute pancreatitis, and one patient presented with jaundice. INTERVENTION Endoscopic incision and marsupialization of the cysts was performed by using a variety of endoscopic tools (needle-knife and regular sphincterotomes, cystotomes, and polypectomy snares). MAIN OUTCOME MEASUREMENTS Technical success of endoscopic intervention and long-term clinical recurrence of symptoms. RESULTS No major complications occurred. All patients remained asymptomatic at a median follow-up of 7.3 years. LIMITATIONS Retrospective study; the small number of patients. CONCLUSIONS The endoscopic treatment of symptomatic intraluminal duodenal duplication cysts is a safe and effective technique, with excellent long-term results. It represents a minimally invasive alternative to surgical resection and might be considered the preferred therapeutic modality for these cases.
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