A rare case of acute abdomen in the adult: The intestinal duplication cyst. case report and review of the literature

Adenocarcinoma originating from a colonic duplication cyst: A case report

BACKGROUND

Gastrointestinal duplication is a rare congenital anomaly of the digestive tract, with colonic manifestations being particularly uncommon. Malignant transformation of colonic duplication cysts is rare, with adenocarcinoma being the most frequently reported type. Herein, we report a rare case of adenocarcinoma originating from a colonic duplication cyst.

CASE SUMMARY

A 49-year-old woman was found to have an elevated cancer antigen 19-9 level during a routine checkup. Imaging revealed a well-defined abdominal cavity cystic mass, which was initially suspected to be an ovarian teratoma. Laparoscopic surgery revealed a duplication cyst, and pathological examination confirmed adenocarcinoma arising from the cyst. The mass within the transverse mesocolon was successfully excised by a colorectal surgeon. Immunohistochemical analysis confirmed adenocarcinoma with invasion into the muscularis propria. Postoperative endoscopy and positron emission computed tomography scan showed no signs of malignancy, except for an elevated cancer antigen 19-9 level. A multidisciplinary team recommended no further chemotherapy, advising routine follow-up for monitoring.

CONCLUSION

Colonic duplications, though rare, remain a differential diagnosis of unexplained abdominal masses, with complete resection being their primary treatment approach.

Surgical management of a cervical oesophageal duplication cyst with tracheal communication in a dog

Foregut duplication cysts can arise anywhere in the gastrointestinal system, leading to non-specific clinical signs in small animals. There are few reports of foregut duplication cysts in the literature that have been managed surgically. This report describes a case of multilevel foregut duplication cysts in a dog, including a cervical oesophageal duplication cyst with tracheal communication. Surgical treatment by resection resulted in the resolution of clinical signs. No clinical evidence of recurrence was noted at 12 months post-operatively. Surgical resection may be a feasible option for the management of foregut duplication cysts that cause clinical signs in dogs.

Tubular adenoma arising in tubular colonic duplication: a case report

Colonic duplication constitutes a rare congenital anomaly, characterized by the presence of hollow cystic or tubular structures exhibiting an epithelial-lined intestinal wall. Diagnostic challenges persist due to its low incidence and manifestation of nonspecific symptoms such as abdominal pain or constipation, resulting in a reluctance to pursue surgical resection. As associated malignancies in colonic duplication are rare, the inherent malignant potential of these anomalies remains undetermined. Additionally, despite reported instances of associated malignancies in colonic duplication, there is an absence of reports in the literature detailing tubular adenoma within these cases. The histologic features of the presented case are particularly noteworthy, situated at the precancerous stage, intimating potential progression towards adenocarcinoma within colonic duplication.

Jejunal duplication cyst in a female neonate: a case report

Introduction and importance

Duplications are the abnormal portion of the intestine, either externally attached to the intestine or intrinsically placed within the bowel lumen. Their prevalence is noted to be around one in 25 000 deliveries. The rare gastrointestinal tract duplication may be located in any part of the gastrointestinal system from the oral cavity to the anus. The most common site of enteric duplication cyst (DC) is the terminal part of the ileum. Hence, duplications in jejunum are rare.

Case presentation

Hereby, the authors report a case of jejunal DC in a female neonate which was managed successfully via surgery and adequate post-operative care without any complications.

Clinical discussion

Duplications are more frequently single. They are usually located in the mesenteric border of the associated native bowel and may vary in shape and size. Most of them are cystic, followed by tubular and mixed type, with or without other congenital anomalies. More than 80% of the cases present before the age of 2 years as an acute abdomen or bowel obstruction, but many duplications remain silent unless complications occur, and therefore may not be diagnosed until adulthood. Complications of enteric DC include volvulus, bleeding, and, rarely, malignant degeneration.

Conclusion

It is important for paediatric surgeons to include DC in the differential diagnosis if a neonate presents with features of intestinal obstruction.

Complete colonic duplication presenting as hip fistula in an adult with pelvic malformation: A case report

BACKGROUND

Alimentary tract duplication (ATD) is a rare congenital anomaly. Thus, a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very distinctive. These characteristics show the variability of this disease and explain why it tends to be challenging to diagnose and treat.

CASE SUMMARY

A 25-year-old woman with a history of a fistula opening in her right hip since birth presented with the irregular discharge of foul fluid from the fistula and intermittent abdominal pain. Contrast-enhanced computed tomography and magnetic resonance imaging findings revealed a duplicated tube isolated in her abdominal pelvic cavity along with a pelvic malformation and double ureter. Right foot radiographic examination showed pes cavus. During surgery, the tube appeared to be an almost complete colonic structure and was verified to be connected to the fistula. All of the involved tissue and fistula were removed, and the defect in the pelvic floor was closed by suturing after surgery. After 8 mo, the postoperative follow-up has been uneventful.

CONCLUSION

ATD may be a differential diagnosis in sinus tract cases. Laparoscopy combined with open surgery is a viable treatment option.

Intussusception Caused by Cecal Duplication in an Adult: A Case Report

Cecal duplication is a rare congenital malformation and majority of the cases are discovered in the first years of life. Ileocolic intussusception is also a rare situation encountered in adults. A 19-year-old female presented with acute abdominal pain and bowel occlusion in relation with an ileocecal intussusception. She underwent an emergent laparotomy and ileocecal resection. A cecal duplication cyst was found to be the cause of the intussusception. While duplications and intussusception are very rare situations encountered in the adult life, the presence of both at the same time remains frankly anecdotal. The present case demonstrates that intussusception may likely be involved with any cecal lesion, like duplication.

Incidental finding of jejunal duplication cyst during laparotomy: A case report

Introduction

and importance: Duplications, which rare anomalies of the gastroin-testinal tract, may be located in any part of the gastro-intestinal system from the oral cavity to the anus. The aim of this paper is to present and discuss a case of an asymptomatic jejunal duplication cyst associated with adhesive small bowel obstruction in an elderly lady.

Case presentation

A 70-year-old female, presented to the emergency room with a history of recurrent abdominal, non-bilious vomiting, and abdominal distension for 5 days with no passage of stool and flatus for 3 days. Abdominal Computed tomography scan showed dilated fluid-filled small bowel loops with abrupt transition to collapsed small bowel associated with a focal kink and narrowing of the lumen. The patient was rushed for emergency laparotomy for diagnosis of adhesive small bowel obstruction. To our surprise, jejunal duplication cysts were found.

Clinical discussion

the intestinal duplication cysts are rare congenital anomalies. The clinical presentation is variable and depends on the site and the related complications. Surgical resection is deemed appropriate management due to known complications like obstruction, hemorrhage, perforation, and malignant degeneration.

Conclusion

It's important to include intestinal duplication in the differential diagnosis of acute abdomen.

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Duplications of the gastrointestinal tract are rare congenital anomalies.

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Duplications are located on the mesenteric border of the associated native bowel.

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The resection of the involved bowel is the treatment associated with the best long-term outcomes.

Gastrointestinal duplication cysts: what a radiologist needs to know

Gastrointestinal tract duplication cysts are rare congenital malformations which can be diagnosed as early as the prenatal period but are frequently found in infancy or incidentally in adulthood. They can be seen throughout the alimentary tract with the most common involving the distal ileum and second most common the esophagus. Many duplication cysts are asymptomatic and thus discovered as an incidental imaging finding, though they can also be symptomatic with an array of clinical presentations dependent largely on their location. The vast majority of duplication cysts are benign; however, there are rare instances of malignant transformation reported. The aim of this review is to show how multimodality imaging can help in the diagnosis of duplication cysts at various anatomical locations. Duplication cyst can become symptomatic and in rare cases undergo malignant transformation; therefore, they are typically managed with surgical excision, particularly if found prenatally or during infancy. Given the diversity of anatomic locations, multiple differential diagnoses, and the need for surgical intervention, it is valuable to comprehend the role of multimodality imaging role in diagnosing duplication cysts.

Gastrointestinal duplication masquerading as intussusception in an adult

Gastrointestinal duplication is a rare congenital condition that involves tissues anywhere along the alimentary tract. It may also be referred to as enteric duplication or alimentary tract duplication. It typically presents in children and is hardly found in adults because the presentation varies and the diagnosis is often incidental. Surgical resection is generally indicated to prevent future complications. We present a case of duplicated small bowel discovered during surgery in a young female with the initial diagnosis of small bowel intussusception on CT.

Asymptomatic Enteric Duplication Cyst in a Geriatric Cat: Case Report and Review of the Literature

An 11 yr old female neutered domestic shorthair presented for an 8 mo history of an asymptomatic abdominal mass. Computed tomography described an irregular, cystic structure closely associated with the duodenum, and focal ultrasonography confirmed the mass shared outer layers with the intestinal wall. Coeliotomy revealed the mass was originating from, and firmly adhered to, the antimesenteric border of the duodenum but was not communicating with the intestinal lumen. En bloc mass resection with omentalization was performed without small intestinal resection. Histopathology confirmed an enteric duplication cyst. The cat made a full recovery and remained asymptomatic postoperatively with no evidence of recurrence. A review of the literature confirms the duodenum to be the most common location of enteric duplication cysts in felines and that subtotal excision is curative in most cases. This differential should be considered in cases of cystic gastrointestinal structures in juvenile and adult felines, with or without associated clinical signs. In cases of luminal involvement or malignant transformation, intestinal resection and anastomosis is more appropriate. This report describes the presentation, investigations, and treatment of an asymptomatic duodenal duplication cyst in an adult feline and summarizes and compares current knowledge of the condition between veterinary and human literature.

Successful management of tubular colonic duplication using a laparoscopic approach: A case report and review of the literature

BACKGROUND

Alimentary duplication is a rare congenital disease with a reported incidence of 1 per 4500 persons, although the exact incidence has been difficult to ascertain. According to previous reports, the most common site of duplication is the ileum, and colonic duplication is rare. Due to different types and locations of the duplication, the manifestations are varied, which makes establishing an accurate diagnosis before surgery a challenge.

CASE SUMMARY

A 17-year-old female patient sought evaluation in our department with constipation and chronic abdominal pain for 12 years; she had difficulty defecating and had dry stools since she was a child. An abdominal computed tomography revealed two extremely enlarged loops of bowel full of stool-like intestinal contents in the left lower abdomen, which led us to consider the possibility of colonic duplication. A laparoscopic exploration was performed, which revealed a tubular duplicated colon that shared a common opening with the transverse colon. A left hemi-colectomy was performed with a side-to-side anastomosis. The pathologic results confirmed the diagnosis. At the 6-mo follow-up, the patient was doing well without constipation or abdominal pain.

CONCLUSION

Colonic duplication is a rare alimentary abnormality in adults. Due to the non-specific manifestations and low incidence, it is usually difficult to make an accurate diagnosis pre-operatively. Surgery is the mainstay of treatment, even though some patients are asymptomatic.