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Alfayez AA, Skef Z. Cecal Duplication Cyst: A New Surgical Intervention. Cureus 2023; 15:e44613. [PMID: 37799260 PMCID: PMC10547584 DOI: 10.7759/cureus.44613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/07/2023] Open
Abstract
This case report of an infant details a rare occurrence of a cecal duplication cyst causing bowel obstruction. It was successfully treated through an extra mucosal enucleation. The patient presented at 41 days of life, with two days picture of abdominal distension and recurrent non-bilious vomiting. The infant improved initially, but subsequently, he developed bilious vomiting. Further investigations revealed a suspected ileocolic intussusception and small bowel obstruction. Surgical exploration revealed a cecal duplication cyst. The cyst was enucleated, and closure of the seromuscular defect was done with an appendectomy. The patient had a smooth recovery postoperatively. Histopathology confirmed the presence of a duplication cyst with benign ectopic gastric tissue negative for malignancy. The patient was discharged without any complications.
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Affiliation(s)
- Adel A Alfayez
- Department of Pediatric Surgery, Prince Sultan Military Medical City, Riyadh, SAU
| | - Zafer Skef
- Division of Pediatric Surgery, Department of Surgery, Security Forces Hospital, Riyadh, SAU
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Deguchi K, Saka R, Watanabe M, Masahata K, Nomura M, Kamiyama M, Ueno T, Tazuke Y, Okuyama H. Ileocecal valve-sparing surgery for duplication cysts in the terminal ileum: two case reports and literature review. Surg Case Rep 2022; 8:130. [PMID: 35792950 PMCID: PMC9259777 DOI: 10.1186/s40792-022-01483-w] [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] [Received: 04/18/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022] Open
Abstract
Background Duplication cysts close to the ileocecal valve are usually treated with ileocecal resection. However, loss of the ileocecal valve will lead to problems, especially in infants. Mucosectomy of the cyst would be a better alternative that preserves the ileocecal valve. We report two cases of duplication cyst in the terminal ileum successfully treated with mucosectomy. Case presentation Case 1. A 3-month-old boy with bilious emesis and abdominal distention was referred to our hospital with a diagnosis of small bowel obstruction caused by an abdominal cyst. Computed tomography revealed a cystic mass compressing the terminal ileum and causing mechanical small bowel obstruction. His general condition deteriorated quickly; emergency laparotomy was performed. Although the small intestines were dilated and partially twisted, there was no necrosis. Following intestinal decompression, a cystic mass adjacent to the terminal ileum was confirmed on the mesenteric side. Cyst mucosectomy was performed to preserve the ileocecal valve. Case 2. A 5-month-old boy with sudden onset of hematochezia was referred to our hospital with a diagnosis of intussusception. Following unsuccessful contrast enemas, emergency surgery was performed. A cystic mass adjacent to the terminal ileum was confirmed; there was no intussusception. Cyst mucosectomy was performed. Both patients had an uneventful postoperative course. Conclusions Cyst mucosectomy, which preserves the ileocecal valve, is safe and effective for treating duplication cysts in the terminal ileum.
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Ileocecal duplication in children: a single-center experience of 115 cases. Eur J Pediatr 2022; 181:3937-3944. [PMID: 36094665 DOI: 10.1007/s00431-022-04611-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/03/2022]
Abstract
UNLABELLED To evaluate the clinical features, surgical management, and prognosis of ileocecal duplication in children. A total of 115 patients diagnosed with ileocecal duplication at Beijing Children's Hospital between January 2010 and June 2021 were retrospectively reviewed. Ileocecal duplications were divided into ileal intraluminal (n = 41), ileal extraluminal (n = 24), ileocecal valve (n = 11), cecal intraluminal (n = 18), and cecal extraluminal (n = 3) types according to their locations. Median age at diagnosis was 9.5 (0.1-169.2) months. Intussusception was only observed preoperatively in patients with the ileal intraluminal (8/41), ileocecal valve (4/11), and cecal intraluminal (7/18) types (P = 0.004). Ileocecal resection and ileocolostomy and cyst excision without ileocecal resection were performed in 41 (35.7%) and 74 (64.3%) patients, respectively. The proportions of cyst excision without ileocecal resection performed in patients with different types were 78.0% (32/41), 91.7% (22/24), 27.3% (3/11), 27.8% (5/18), and 100.0% (3/3) (P < 0.001). Time of oral intake (P = 0.003) and hospital stay after surgery (P < 0.001) were significantly shorter in patients undergoing cyst excision without ileocecal resection. There were no significant differences in the complications, growth, and stool frequency (older than 4 years) between patients undergoing different surgical procedures. Regarding the stool consistency (older than 4 years), there was a lower proportion of dry stool in patients undergoing cyst excision (P = 0.008). CONCLUSIONS Ileocecal duplications at specific locations are prone to intussusception and can influence the surgical procedure choice. At mid-term follow-up, the children's growth and defecation patterns do not seem to be affected by ileocecal resection. WHAT IS KNOWN • How to address ileocecal duplication has always been challenging in clinical management. • Children who have an ileocecal resection can develop some early postoperative complications. WHAT IS NEW • Ileocecal duplications at specific locations are prone to intussusception and can influence the surgical procedure choice. • Children's growth and defecation patterns do not seem to be affected by ileocecal resection.
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Khalid A, Ali T, Ashraf M, Aqeel M, Waqar M, Saeed F. Cecal duplication cyst mimicking intussusception in a female: A case report. Int J Surg Case Rep 2022; 100:107767. [DOI: 10.1016/j.ijscr.2022.107767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
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Intussusception Caused by Cecal Duplication in an Adult: A Case Report. Case Rep Surg 2022; 2022:9520191. [PMID: 36262933 PMCID: PMC9576413 DOI: 10.1155/2022/9520191] [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] [Received: 08/25/2022] [Accepted: 09/28/2022] [Indexed: 11/25/2022] Open
Abstract
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.
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Dajenah M, Ahmed F, Almohtadi A, Thabet A, Ghaleb K, Al-Yousofy F, Mohammed F. Cecal duplication cyst presenting with acute abdomen: a case report. Pan Afr Med J 2022; 41:280. [PMID: 35784599 PMCID: PMC9206177 DOI: 10.11604/pamj.2022.41.280.33731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/01/2022] [Indexed: 11/11/2022] Open
Abstract
Cecal duplication cyst is a rare congenital malformation with a few reported adult cases. We present a 23-year-old man who presented with low-grade fever, constipation, and right lower quadrant pain for three days. An abdominal computed tomography scan showed a cystic mass of 8.8x7.5x6 cm adjoining to the posterior wall of the cecum. The patient underwent abdominal laparotomy, and a right hemicolectomy was performed with resection of the duplication cyst. The histopathological study confirmed the diagnosis of a non-communicating cecal duplication cyst. In conclusion, it is essential to include cecal duplication cyst in the differential diagnosis of the acute abdomen to guarantee the best treatment strategy.
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Affiliation(s)
- Menawar Dajenah
- Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Faisal Ahmed
- Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Abdullatif Almohtadi
- Department of Radiology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Anessa Thabet
- Department of Gynecology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Khaled Ghaleb
- Department of Internal Medicine, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Fayed Al-Yousofy
- Department of Pathology, Faculty of Medicine, Taiz University of Medical Science, Taiz, Yemen
| | - Fawaz Mohammed
- Department of Orthopedy, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
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Anadolulu Aİ, Gerçel G, Kocaman OH. Rare cecum pathologies as a cause of acute abdomen in children. ULUS TRAVMA ACIL CER 2022; 28:249-253. [PMID: 35485572 PMCID: PMC10493532 DOI: 10.14744/tjtes.2020.79357] [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] [Received: 07/17/2020] [Accepted: 12/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND We aimed to present cecum pathologies which are the cause of acute abdomen. METHODS Between January 2015 and June 2019, patients that were operated with the diagnosis of acute abdomen and patients with the primary cecum pathologies were evaluated retrospectively. RESULTS There were eight patients, five males and three females. The mean age was 7.2±2.9 years. Complaints were abdominal pain and vomiting in all patients. Physical examination was consistent with acute abdomen. In the imaging studies, the preliminary diagnosis was considered as two patients had acute appendicitis, two had invagination (one due to Meckel diverticulum and one with mesenteric cyst), two had ileus, one had perforated appendicitis, and one had cecum diverticulum. In surgery, five patients had cecum mass, one had cecum diverticulitis, one had cecum volvulus, and one had inflamed necrotic cecum. All patients underwent cecum resection and ileocolonic anastomosis. Histopathologic examination was resulted as Burkitt's lymphoma in three patients, cecum diverticulum in two, duplication of cecum in one, tuberculosis of cecum in one, and gangrenous necrosis due to volvulus in one patient. The mean follow-up period was 25 months (2 months-4 years). Follow-up was uneventful. CONCLUSION Primary cecum pathologies are very rare. This leads to lack of standardization in treatment planning. Considering the patients with malignancy in the series, ileocolonic anastomosis with cecum resection is an adequate and appropriate treatment option in children with primary cecum pathology.
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Affiliation(s)
- Ali İhsan Anadolulu
- Department of Pediatric Surgery, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa-Turkey
| | - Gonca Gerçel
- Department of Pediatric Surgery, ŞanlıurfaTraining and Research Hospital, Şanlıurfa-Turkey
| | - Osman Hakan Kocaman
- Department of Pediatric Surgery, Harran University Faculty of Medicine, Şanlıurfa-Turkey
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Corroppolo M, Pani E, Bortolami MT, Sadri HR, Beretta F, Revetria C, Mazzero G, Ciardini E. Caecal duplication, a case report. LA PEDIATRIA MEDICA E CHIRURGICA 2021; 43. [PMID: 34672177 DOI: 10.4081/pmc.2021.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 09/22/2021] [Indexed: 11/23/2022] Open
Abstract
The caecum is one of the rarest sites of intestinal duplication cysts. The most common symptomatology includes vomiting, abdominal pain, abdominal distention, palpable mass and rectal bleeding. Most of the duplications are diagnosed within the first two years of life, including prenatal diagnosis. Only few cases of caecal duplication have been reported in the literature up to the present day. We are going to present a case of a five-years old girl with caecum duplication who reached our ward due to abdominal distension with no other symptoms.
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Affiliation(s)
| | - Elisa Pani
- U.O.C. Chirurgia Pediatrica, Ospedale Santa Chiara, Trento.
| | | | | | - Fabio Beretta
- U.O.C. Chirurgia Pediatrica, Ospedale Santa Chiara, Trento.
| | - Clara Revetria
- U.O.C. Chirurgia Pediatrica, Ospedale Santa Chiara, Trento.
| | - Giosuè Mazzero
- U.O.C. Chirurgia Pediatrica, Ospedale Santa Chiara, Trento.
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Akkary R, Diab N. A rare cause of neonatal intussusception. Considering it might reduce the mortality. A case report and a review of the literature. Int J Pediatr Adolesc Med 2021; 8:48-51. [PMID: 33718578 PMCID: PMC7922833 DOI: 10.1016/j.ijpam.2019.11.006] [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] [Received: 08/21/2019] [Accepted: 11/21/2019] [Indexed: 10/26/2022]
Abstract
Full-term neonatal intussusception is rare. Cecal duplication as a lead point for intussusception is very rare. We report a case of full-term neonate with ileo-cecal intussusception due to cecal duplication. Although cecal duplication represents rarely a surgical emergency, intussusception always needs immediate attention. The awareness of this entity is essential for diagnosis and management.
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Affiliation(s)
| | - Nabil Diab
- Faculty of Medicine, University of Balamand, Lebanon
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Saxena R, Pathak M, Sinha A. Caecal duplication cyst: A rare disease with variable presentation and its management in the era of laparoscopy. J Minim Access Surg 2019; 16:71-73. [PMID: 30618426 PMCID: PMC6945338 DOI: 10.4103/jmas.jmas_220_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Duplication cysts of the intestine are a rare congenital anomaly that can occur anywhere throughout the length of intestine and can be either cystic or tubular. Around two dozen cases of caecal duplication cyst (CDC) are reported in the literature with variable presentation. We describe three cases of CDC who presented at variable age and with variable presentation. None of the imaging study could confirm the site of the duplication, preoperatively. All patients underwent laparoscopy-assisted resection and anastomosis. All patients are free of any complications at median follow-up of 24 months.
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Affiliation(s)
- Rahul Saxena
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Manish Pathak
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Arvind Sinha
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Pediatric Intussusception: The Cinnamon Bun Sign. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2018. [DOI: 10.1177/8756479318771612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Acute abdominal pain in the pediatric patient is a common clinical symptom often resulting in uncertainty and thus often subsequently leads to a sonographic examination of the abdomen. Sonography is often the modality of choice for pediatric abdominal imaging, and consequently, sonographers should have a fundamental appreciation for the causes of acute abdominal pain in the pediatric population. Intussusception, which is the telescoping of a proximal segment of bowel into a distal segment, is one potential cause of acute abdominal pain for these patients. This review clarifies the etiology and classification of intussusception and provides an overview of the clinical manifestations, sonographic identification, and treatment of this potentially severe disorder. Also, this review provides a novel imaging sign, called the “cinnamon bun” sign, that sonographers can employ while examining patients for possible intussusception. The cinnamon bun sign is a descriptive term that may be used to illustrate a transverse sonographic plane through an intussusception.
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Radhakrishna V, Rijhwani A, Jadhav B. Cecal duplication: A mimicker of intussusception: A case report and review. Ann Med Surg (Lond) 2018; 31:17-19. [PMID: 29922463 PMCID: PMC6004772 DOI: 10.1016/j.amsu.2018.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/08/2018] [Accepted: 05/28/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Cecal duplication is a rare congenital anomaly and to the best of our knowledge, only 43 cases have been reported in the literature till date. Most of them present within the first year of life. They can mimic intussusception, and the delay in diagnosis can lead to high morbidity. CASE REPORT A five-year boy presented with pain abdomen for a week. He was found to have ileocolic intussusception. The intussusception could only be partially reduced by the hydrostatic method. On laparotomy, a submucosal solid mass was found in the cecum with multiple enlarged lymph nodes. Mass was resected with clear margins and lymph nodes sampled. Histopathology was conclusive of cecal duplication. Post-operative course was uneventful, and the child is thriving well, last reviewed at three-year follow-up. CONCLUSION Incomplete reduction of intussusception, intussusception with atypical presentation or intussusception in atypical age group should alert to the possibility of cecal duplication.
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Affiliation(s)
| | - Ashok Rijhwani
- Department of Paediatric Surgery, JIPMER, Pondicherry, India
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A case of ileocecal duplication cyst protruding into the intestinal lumen enucleated via an anti-mesenteric approach. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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