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Alomar K, Mansour H, Qatleesh S, Eid N, Alkader MA, Al Dalati H. Diagnosis and surgical management of a rare case of duodenal duplication cyst in a neonate: Case report and literature review. Int J Surg Case Rep 2023; 107:108354. [PMID: 37267789 DOI: 10.1016/j.ijscr.2023.108354] [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: 05/05/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Duodenal duplication cysts are a rare subtype of alimentary tract duplications cysts, consisting of 7 % of all the duplications. The clinical presentation is variable, depending on the size, location and mass effect. Most duodenal duplication cysts abut the second or third portion of the native duodenum. The standard treatment of choice for symptomatic enteric duplication cysts is complete surgical removal. In our case, by examining the abdomen, ectopic pancreatic tissue was found on the wall of the transverse colon, along with Meckel's diverticulum, 50 cm from the ileocecal junction. CASE PRESENTATION We present a newborn case presented to the hospital with a history of abdominal mass with jaundice. Abdominal ultrasonography and CT scan show the presence of a cystic mass without specifying its exact source. By opening the abdomen, it was found at the expense of the duodenum, and it was excised and On histopathological analysis, a duodenal duplication cyst was diagnosed. The literature was reviewed and the approach to duodenal duplication cyst in neonates is discussed. CLINICAL DISCUSSION Duodenal duplication cysts are rare, even so should be taken into consideration when a mass is found. A thorough imaging investigation is crucial in establishing the diagnosis along with histopathology. CONCLUSION When diagnosing a Duodenal duplication cysts, the cyst must be completely removed because potential risk of malignant transformation.
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Affiliation(s)
- Khaled Alomar
- Damascus University, University Pediatrics' Hospital, Syrian Arab Republic.
| | - Hasan Mansour
- Damascus University, University Pediatrics' Hospital, Syrian Arab Republic
| | - Safaa Qatleesh
- Damascus University, Al Assad University Hospital, Syrian Arab Republic
| | - Nader Eid
- Damascus University, University Pediatrics' Hospital, Syrian Arab Republic
| | | | - Husam Al Dalati
- Damascus University, University Pediatrics' Hospital, Syrian Arab Republic
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Hakda RY, Makwana DV, Shukla R, Parikh U, Chandna SB. Isolated duodenal duplication cyst in a neonate. Afr J Paediatr Surg 2022; 19:257-260. [PMID: 36018210 PMCID: PMC9615949 DOI: 10.4103/ajps.ajps_176_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Duodenal duplication cysts are a rare subtype of alimentary tract duplications cysts, consisting of 7% of all the duplications. We report a rare case of neonatal duodenal duplication cyst presenting as a palpable abdominal mass and features of gastric outlet obstruction. A 27-day-old male child presented with complaints of icterus, non-bilious vomiting after every feed and right-sided abdominal lump for the last 15 days. A computed tomography scan of the abdomen revealed well-defined peripherally enhancing cystic lesion noted in the subhepatic region extending up to the right lumbar region. On surgical exploration, a cystic mass was found attached to the pyloric part of the stomach along the mesenteric border of the first, second and third part of the duodenum, which was marsupialised, and no communication was found with the duodenum. On histopathological analysis, a duodenal duplication cyst was diagnosed without any heterotopic mucosa. The literature was reviewed and the approach to duodenal duplication cyst in neonates is discussed.
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Affiliation(s)
- Riyazhussein Yakoob Hakda
- Department of General Surgery, SVP Institute of Medical Sciences and Research, NHL Municipal Medical College, Ahmedabad, Gujarat, India
| | - Deepen V Makwana
- Department of General Surgery, SVP Institute of Medical Sciences and Research, NHL Municipal Medical College, Ahmedabad, Gujarat, India
| | - Ramendra Shukla
- Department of Paediatric Surgery, SVP Institute of Medical Sciences and Research, NHL Municipal Medical College, Ahmedabad, Gujarat, India
| | - Urvish Parikh
- Department of Paediatric Surgery, SVP Institute of Medical Sciences and Research, NHL Municipal Medical College, Ahmedabad, Gujarat, India
| | - Sudhir B Chandna
- Department of Paediatric Surgery, SVP Institute of Medical Sciences and Research, NHL Municipal Medical College, Ahmedabad, Gujarat, India
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Bulotta AL, Stern MV, Moneghini D, Parolini F, Bondioni MP, Missale G, Boroni G, Alberti D. Endoscopic treatment of periampullary duodenal duplication cysts in children: Four case reports and review of the literature. World J Gastrointest Endosc 2021; 13:529-542. [PMID: 34733413 PMCID: PMC8546566 DOI: 10.4253/wjge.v13.i10.529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/30/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Duodenal duplications are rare congenital anomalies of the gastrointestinal tract. As the periampullary variant is much rarer, literature is scant and only few authors have reported their experience in diagnosis and treatment, particularly with operative endoscopy.
CASE SUMARY To report our experience with the endoscopic treatment in a series of children with periampullary duodenal duplication cysts, focusing on the importance of obtaining an accurate preoperative anatomic assessment of the malformations. The pediatric periampullary duodenal duplication cyst literature is reviewed. We conducted a systematic review according to the PRISMA guidelines. The PubMed database was searched for original studies on “duodenal duplication”, “periampullary duplication” or “endoscopic management” published since 1990, involving patients younger than 18 years of age. Eligible study designs were case report, case series and reviews. We analyzed the data and reported the results in table and text. Fifteen eligible articles met the inclusion criteria with 16 patients, and analysis was extended to our additional 4 cases. Median age at diagnosis was 13.5 years. Endoscopic treatment was performed in 10 (50%) patients, with only 2 registered complications.
CONCLUSION Periampullary duodenal duplication cysts in pediatric patients are very rare. Our experience suggests that an accurate preoperative assessment is critical. In the presence of sludge or stones inside the duplication, endoscopic retrograde cholangio-pancreatography is mandatory to demonstrate a communication with the biliary tree. Endoscopic treatment resulted in a safe, minimally invasive and effective treatment. In periampullary duodenal duplication cyst endoscopically treated children, long-term follow-up is still necessary considering the potential malignant transformation at the duplication site.
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Affiliation(s)
- Anna Lavinia Bulotta
- Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
| | - Maria Vittoria Stern
- Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
| | - Dario Moneghini
- Department of Digestive Endoscopy, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
| | - Filippo Parolini
- Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
| | - Maria Pia Bondioni
- Department of Pediatric Radiology, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
| | - Guido Missale
- Department of Digestive Endoscopy, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
| | - Giovanni Boroni
- Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
| | - Daniele Alberti
- Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy
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de Campos ST, Rio-Tinto R, Bispo M, Marques S, Fidalgo P, Devière J. Endoscopic Management of Symptomatic Duodenal Duplication Cysts: Two Case Reports. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2021; 29:356-361. [PMID: 36159200 PMCID: PMC9485914 DOI: 10.1159/000518586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/03/2021] [Indexed: 11/19/2022]
Abstract
Background Duodenal duplication cysts (DDCs) are rare congenital anomalies typically manifesting during childhood. Clinical manifestations are uncommon in adulthood. DDCs were classically treated surgically, but endoscopic treatment has been increasingly reported. Endoscopic cyst marsupialization establishes a communication between the cyst cavity and the duodenal lumen so that the cystic content can be drained continuously into the duodenum. We herein describe two cases of symptomatic DDCs diagnosed in adulthood and submitted to endoscopic marsupialization using different techniques and devices. Case Summary Case 1: A 23-year-old female patient was admitted with the diagnosis of acute pancreatitis. Endoscopic ultrasound revealed a 35-mm duodenal subepithelial lesion whose proximal limit was immediately distal to the ampulla of Vater and filled with fluid and calcifications. Using a duodenoscope, deroofing of the lesion was made with a diathermic snare. Pathology confirmed the diagnosis of DDC. Case 2: A 41-year-old female, submitted to laparoscopic cholecystectomy 1 month earlier due to suspected lithiasic acute pancreatitis, was admitted due to suspicion of iatrogenic biliary fistula. An endoscopic retrograde cholangiopancreatography was performed and the bile leak was treated. Immediately distal to the papillary orifice, a 20-mm subepithelial lesion was also detected. A biopsy forceps was used to fenestrate its wall, allowing the exit of mucous fluid and stones, and a sphincterotome was used to expand the incision. No recurrence was documented in both cases. Conclusion These cases highlight DDC as a potential cause for acute pancreatitis in adults and endoscopy as an easy treatment option.
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Affiliation(s)
- Sara Teles de Campos
- Gastroenterology Department, Digestive Oncology Unit, Champalimaud Foundation, Lisbon, Portugal
- * Sara Teles de Campos,
| | - Ricardo Rio-Tinto
- Gastroenterology Department, Digestive Oncology Unit, Champalimaud Foundation, Lisbon, Portugal
| | - Miguel Bispo
- Gastroenterology Department, Digestive Oncology Unit, Champalimaud Foundation, Lisbon, Portugal
| | - Susana Marques
- Gastroenterology Department, Digestive Oncology Unit, Champalimaud Foundation, Lisbon, Portugal
| | - Paulo Fidalgo
- Gastroenterology Department, Digestive Oncology Unit, Champalimaud Foundation, Lisbon, Portugal
| | - Jacques Devière
- Gastroenterology Department, Digestive Oncology Unit, Champalimaud Foundation, Lisbon, Portugal
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasmus University Hospital − Université Libre de Bruxelles, Brussels, Belgium
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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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