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Nakagawa Y, Uchida H, Makita S, Tainaka T, Hinoki A, Shirota C, Sumida W, Amano H, Yasui A, Kano Y, Maeda T, Kato D, Gohda Y. Duodenal duplication cyst at the second part of the duodenum with congenital duodenal position anomaly completely resected by laparoscopic partial duodenectomy: a case report. Surg Case Rep 2024; 10:73. [PMID: 38551713 PMCID: PMC10980668 DOI: 10.1186/s40792-024-01875-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/21/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Duodenal duplication cysts (DDC) are rare duplications of the alimentary tract. Their treatment depends on their size and location. A radical treatment is total resection, if possible. However, partial excision, puncture, and marsupialization can be selected to prevent surgical injury to the pancreaticobiliary tract despite the risk of recurrence. There are some reports of pancreaticoduodenectomy for DDC because of the risk of recurrent symptoms and malignancy. However, this is considered excessively invasive for DDC, particularly in pediatric cases, because of its extremely low rate of malignancy and high morbidity and mortality rates. We encountered a case of DDC with a congenital duodenal position anomaly occurring in the second part of the duodenum. Taking advantage of the congenital duodenal position anomaly, the DDC was completely resected without injuring the pancreaticobiliary duct. CASE PRESENTATION A 6-year-old boy was diagnosed with a duodenal duplication cyst with obstruction. There was a congenital duodenal position anomaly. The distal second part of the duodenum was the dorsal side of the proximal second part of the duodenum and ascended upward from the proximal second part of the duodenum. The third and fourth parts of the duodenum ran downward to the left and posterior parts of the portal vein, forming the ligament of Treitz. Complete laparoscopic resection of the duodenal duplication cyst and the second to fourth parts of the duodenum, and duodenojejunostomy with retrocolic reconstruction was performed because the duodenum was easily mobilized to the ligament of Treitz owing to the duodenal position anomaly. The duodenojejunostomy with retrocolic reconstruction achieved a more physiologically normal appearance compared to what would have been achieved with a Roux-en-Y reconstruction. The patient was discharged on postoperative day 12 without any complications. CONCLUSIONS The procedure used in this case might not be easily applied in all laparoscopy cases. However, it could be an option for duodenal duplication cysts with congenital duodenal position anomalies.
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Affiliation(s)
- Yoichi Nakagawa
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Hiroo Uchida
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan.
| | - Satoshi Makita
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Takahisa Tainaka
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Akinari Hinoki
- Department of Rare/Intractable Cancer Analysis Research, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Chiyoe Shirota
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Wataru Sumida
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Hizuru Amano
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Akihiro Yasui
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Yoko Kano
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Takuya Maeda
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Daiki Kato
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
| | - Yousuke Gohda
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan
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Mashlah Q, Al Laham O, Odah Bashi H, Sharaf Aldeen R, Alashi S, Abdulkader M. Thoracoabdominal duplication accompanied by intestinal malrotation: a case report and literature review of a rare congenital anomaly in an infant. Ann Med Surg (Lond) 2024; 86:1166-1172. [PMID: 38333278 PMCID: PMC10849408 DOI: 10.1097/ms9.0000000000001654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/13/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction and importance Thoracoabdominal duplication and intestinal malrotation are extremely rare congenital alimentary tract anomalies that can manifest in any segment of the gastrointestinal tract. Still, tubular duplications are an even rarer subset of alimentary tract duplications. Misdiagnosis could occur and this will yield devastating ramifications. Therefore, consideration in the clinical settings is warranted to aid in conducting timely therapeutic interventions. Case presentation In this article, we illustrate the overwhelmingly rare occurrence of thoracoabdominal duplication coexistent with intestinal malrotation in a 7-month-old male whose primary complaint was chronic dyspnoea since birth that progressed to involve cough and fever. Imaging analysis revealed a significant intrathoracic fluid-filled cyst. Clinical discussion The intestinal malrotation was treated through Ladd's procedure, and surgical excision of the duplicated segments was accomplished. The subsequent analysis of the resected specimens via means of histopathology utilizing Hematoxylin and Eosin dyes established the definitive diagnosis of a foregut duplication cyst. Conclusion Thoracoabdominal duplication is one of the most crucial topics in the field of Paediatric Surgery. It is exceptionally rare in occurrence, and the scarcity of available resources that document and describe this topic is evident in the published literature. The authors must opt to document, study, and broaden awareness regarding this life-threatening pathology so that they can circumvent the resultant complications by means of early detection and the performance of apt surgical interventions. Upon careful review of the available literature, we can state that ours is the first-ever case documented from their country regarding this topic and this co-incidence.
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Affiliation(s)
- Qusai Mashlah
- Faculty of Medicine
- Department of Pediatric Surgery, Children’s University Hospital
| | | | - Hajar Odah Bashi
- Faculty of Medicine
- Department of Pediatric Surgery, Children’s University Hospital
| | - Rahaf Sharaf Aldeen
- Faculty of Medicine
- Department of Surgery, Al-Mouwasat University Hospital
- Department of Surgery, Al Assad University Hospital, Damascus University, Damascus, (The) Syrian Arab Republic
| | | | - Mohammd Abdulkader
- Faculty of Medicine
- Department of Pediatric Surgery, Children’s University Hospital
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Molla YD, Sisay MA, Abera SA, Abebe B, Adisu GD. Appendiceal duplication an unusual cause of abdominal pain: A case report. Clin Case Rep 2023; 11:e8279. [PMID: 38046802 PMCID: PMC10689292 DOI: 10.1002/ccr3.8279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/14/2023] [Accepted: 11/18/2023] [Indexed: 12/05/2023] Open
Abstract
Appendiceal duplication is exceedingly rare, with a prevalence of 0.004% to 0.009% in appendectomy specimens. Appendiceal duplications can occur alone or in conjunction with cecal duplication. The persistence of the temporary embryologic second cecal appendix is hypothesized to cause appendiceal duplications. We present a case of appendiceal duplication in a 26-year-old Ethiopian female patient who had been experiencing abdominal pain in the right lower quadrant for 1 week. She developed anorexia, a loss of appetite, and a low-grade fever as a result of this. She reported direct and rebound mild discomfort in the right lower quadrant on abdominal examination. She was then operated on and she had an appendiceal duplication intraoperatively. As a result, an appendectomy was performed, and the patient was discharged with improved health. To avoid unfavorable patient outcomes and medicolegal difficulties, surgeons and surgical trainees who conduct several appendectomies throughout their training should be aware of the likelihood of appendiceal duplication.
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Affiliation(s)
| | | | - Samuel Addisu Abera
- Department of PathologyCollege of Medicine and Health SciencesGondarEthiopia
| | - Bewketu Abebe
- Department of PathologyCollege of Medicine and Health SciencesGondarEthiopia
| | - Girma Damtew Adisu
- Department of PathologyCollege of Medicine and Health SciencesGondarEthiopia
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Miry N, Karich N, Bakhti M, Deflaoui T, Bennani A. Unusual Presentation of an Ileal Duplication Cyst: A Case Report. Cureus 2023; 15:e38959. [PMID: 37313060 PMCID: PMC10258869 DOI: 10.7759/cureus.38959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
Duplication cyst (DC) of the digestive tract is a rare embryological anomaly, presenting as a cystic formation that could be attached to any part of the digestive tract, it is a thin-walled structure made of two layers, an inner layer that is frequently lined by an alimentary epithelium, surrounded by a smooth muscle layer often shared with the adjacent digestive segment. DCs are most commonly located in the distal ileum; sometimes, they are associated with other visceral or skeletal anomalies. They are frequently discovered during childhood, following a bowel obstruction or abdominal pain. Here we report a rare case of an ileal DC lined by a pseudostratified and ciliated epithelium, discovered in an adult patient following intestinal obstruction syndrome.
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Affiliation(s)
- Nadir Miry
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Nassira Karich
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Mohammed Bakhti
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Tarik Deflaoui
- Department of Visceral Surgery and Digestive Oncology, Mohammed VI University Hospital, Oujda, MAR
| | - Amal Bennani
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
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Stempfhuber M, Glas A, Raichle U, Wettstein M. [A 19-year-old female patient with acute pancreatitis of unusual cause]. Inn Med (Heidelb) 2023:10.1007/s00108-023-01497-y. [PMID: 36988655 DOI: 10.1007/s00108-023-01497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 03/30/2023]
Abstract
We report the case of a 19-year-old woman with abdominal pain and diarrhea. The diagnosis of acute pancreatitis could be made clinically and through laboratory tests. The cause was a duodenal duplication cyst in the area of the papilla, which was initially relieved endoscopically. Once the acute inflammation had healed, the cyst was resected endoscopically to prevent recurrence and the increased risk of malignancy. Duodenal duplication cysts in the papillary area are a very rare (congenital) cause of acute pancreatitis. If a cyst is present in the area of the duodenal wall, however, this differential diagnosis should be considered. Resection is indicated for therapy.
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Affiliation(s)
- M Stempfhuber
- I. Medizinische Klinik, Gastroenterologie, Hepatologie, Nephrologie, Akutgeriatrie, Infektiologie, Stoffwechselerkrankungen, Ernährungsmedizin, Rheumatologie und Allgemeine Innere Medizin, Klinikum Passau, Passau, Deutschland.
| | - A Glas
- I. Medizinische Klinik, Gastroenterologie, Hepatologie, Nephrologie, Akutgeriatrie, Infektiologie, Stoffwechselerkrankungen, Ernährungsmedizin, Rheumatologie und Allgemeine Innere Medizin, Klinikum Passau, Passau, Deutschland
| | - U Raichle
- I. Medizinische Klinik, Gastroenterologie, Hepatologie, Nephrologie, Akutgeriatrie, Infektiologie, Stoffwechselerkrankungen, Ernährungsmedizin, Rheumatologie und Allgemeine Innere Medizin, Klinikum Passau, Passau, Deutschland
| | - M Wettstein
- I. Medizinische Klinik, Gastroenterologie, Hepatologie, Nephrologie, Akutgeriatrie, Infektiologie, Stoffwechselerkrankungen, Ernährungsmedizin, Rheumatologie und Allgemeine Innere Medizin, Klinikum Passau, Passau, Deutschland
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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] [What about the content of this article? (0)] [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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Yan J, Lei W, Yan J, Ding C, Liu T, Chen Y. Ileocecal duplication in children: a single-center experience of 115 cases. Eur J Pediatr 2022; 181:3937-44. [PMID: 36094665 DOI: 10.1007/s00431-022-04611-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [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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CAGLAR OSKAYLI M, ERSOY F, GULCIN N, PIRIM A, OZEL SK, OZKANLI S, ULUKAYA DURAKBASA C. Gastrointestinal Tract Duplications in Children: A Tertiary Referral Center Experience. Medeni Med J 2022; 37:138-144. [PMID: 35734973 PMCID: PMC9234364 DOI: 10.4274/mmj.galenos.2022.46383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Methods: Results: Conclusions:
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Modak A, Dhir SK, Khan AA, Rastogi P, Peters NJ, Mukhopadhyay K. Antenatally Detected Multiple Mediastinal Enterogenous Cysts in a Newborn Presenting with Severe Cardio-Respiratory Compromise and Early Life-Saving Management. J Indian Assoc Pediatr Surg 2021; 26:192-194. [PMID: 34321793 PMCID: PMC8286024 DOI: 10.4103/jiaps.jiaps_91_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 08/02/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022] Open
Abstract
Posterior mediastinal enterogenous cyst is a rare entity in neonate. The neonate can present with severe cardio-respiratory compromise in the form of respiratory distress, shock, cardiac failure or arrhythmia soon after birth which may require immediate surgical intervention. Antenatal screening can demonstrate the cystic mass in fetus early and can help in quick postnatal management. Multidisciplinary management with aspiration of the cysts was life-saving in the present case.
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Affiliation(s)
- Abhijit Modak
- Department of Pediatrics, New Born Unit, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Shashi Kant Dhir
- Department of Pediatrics, New Born Unit, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Adil Ahmed Khan
- Department of Pediatrics, New Born Unit, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Pulkit Rastogi
- Department of Histopathology, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Nitin James Peters
- Department of Pediatric Surgery, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Kanya Mukhopadhyay
- Department of Pediatrics, New Born Unit, Post Graduate Institute for Medical Education and Research, Chandigarh, India
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Fusi G, Molinaro F, Ferrara F, Taddei A, Roviello F, Marano L, Rossi F, Costantini M, Cappelli A, Messina M, Angotti R. Gastric duplication presenting as partial gastric outlet obstruction. Journal of Pediatric Surgery Case Reports 2021; 64:101723. [DOI: 10.1016/j.epsc.2020.101723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Kim SH, Cho YH, Kim HY. Alimentary Tract Duplication in Pediatric Patients: Its Distinct Clinical Features and Managements. Pediatr Gastroenterol Hepatol Nutr 2020; 23:423-429. [PMID: 32953637 PMCID: PMC7481056 DOI: 10.5223/pghn.2020.23.5.423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. METHODS We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. RESULTS A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). CONCLUSION ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.
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Affiliation(s)
- Soo-Hong Kim
- Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea
| | - Yong-Hoon Cho
- Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea
| | - Hae-Young Kim
- Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea
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12
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Mansour M, Souliman O, Ismail S, Alsuliman T, Souleiman F. A gastric duplication cyst incidentally discovered during an obesity surgery for a 55-year-old female: a rare case report from Syria. J Surg Case Rep 2020; 2020:rjaa215. [PMID: 32714506 DOI: 10.1093/jscr/rjaa215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/09/2020] [Indexed: 11/14/2022] Open
Abstract
A gastric duplication cyst (GDC) is an uncommon gastrointestinal (GI) tract anomaly in adults. Nonspecific symptoms make it difficult to diagnose, while radiological examination might be helpful. However, the final diagnosis is made after eradication and histopathological study. Herein we report a case of an asymptomatic, incidentally diagnosed gastric duplication cyst discovered during laparoscopic sleeve gastrectomy in a 55-year-old female.
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Affiliation(s)
- Marah Mansour
- Faculty of Medicine, Tartous University, Tartous, Syrian Arab Republic
| | - Ola Souliman
- Faculty of Medicine, Tartous University, Tartous, Syrian Arab Republic
| | - Sawsan Ismail
- Department of Pathology, Faculty of Medicine, Tishreen University, Lattakia, Syrian Arab Republic
| | - Tamim Alsuliman
- Hematology and Cell Therapy Department, Saint-Antoine Hospital, AP-HP, Sorbonne University, Paris, France
| | - Fadi Souleiman
- Department of General Surgery, Faculty of Medicine, Tartous University, Tartous, Syrian Arab Republic
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Abstract
We present a rare case of association of anterior rectal duplication and posterior urethral valve (PUV). A term neonate with no antenatal concerns was admitted with urosepsis and acute renal injury at 18 days of age. History revealed a poor urinary stream and dribbling. After resuscitation and stabilisation, renal tract ultrasound and micturating cysto-urethrogram were performed. Cystourethroscopy showed PUV and a mass indenting the bladder posteriorly. MRI confirmed the presence of a cystic lesion anterior to the rectum suspicious of rectal duplication. Laparoscopic-assisted excision of the anterior rectal duplication cyst was then performed. The infant recovered uneventfully. Creatinine normalised postoperatively and has been stable at follow-up.
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Affiliation(s)
| | | | - Massimo Garriboli
- Paediatric Urology, Evelina London Children's Healthcare, London, UK
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15
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Chen AK, Allshouse MJ. Urachal cyst and enteric duplication in a pediatric patient. Journal of Pediatric Surgery Case Reports 2019. [DOI: 10.1016/j.epsc.2019.101206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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16
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Sharma A, Agarwal S, Kumar M, Sankhwar S. Rectal duplication cyst causing acute urinary retention with bladder outlet obstruction: an unusual presentation. BMJ Case Rep 2019; 12:12/3/e226338. [PMID: 30852494 DOI: 10.1136/bcr-2018-226338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Anterior rectal duplication cyst is rare entity with <50 reported cases to date. It has myriad presentations like bleeding per rectum, constipation, rectal prolapsed and intestinal obstruction due to extrinsic compression of rectum. However, the association of enlarged duplication cyst compressing the bladder neck or ureter, and leading to bladder outlet obstruction or hydroureteronephrosis is extremely rare with only a handful of reported cases. We report a rare case of large anterior rectal duplication cyst in a young girl leading to acute urinary retention with bladder outlet obstruction which was eventually managed by laparoscopic-assisted transabdominal surgical excision of the cyst. The authors believe that such an association has not been previously reported in this age group.
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Affiliation(s)
- Ashish Sharma
- Urology, King George's Medical University, Lucknow, Uttar-Pradesh, India
| | - Samarth Agarwal
- Urology, King George's Medical University, Lucknow, Uttar-Pradesh, India
| | - Manoj Kumar
- Urology, King George's Medical University, Lucknow, Uttar-Pradesh, India
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17
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Abstract
Congenital and hamartomatous lesions of the gastrointestinal tract cause diagnostic challenges for surgical pathologists. Many of these are merely histologic curiosities, whereas others have substantial clinical implications because they herald cancer syndromes or associated anomalies. Although a comprehensive discussion of all developmental abnormalities that can occur in the gastrointestinal tract is beyond the scope of a single manuscript, some entities are more likely to be encountered by surgical pathologists, have important clinical consequences, or pose diagnostic difficulties. The purpose of this review is to discuss the more common malformations and choristomas, as well as hamartomatous lesions that may be clinically important due to their risk for cancer development, frequent associations with heritable cancer syndromes and other anomalies, or potential to simulate other entities.
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Affiliation(s)
- Melanie Johncilla
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Rhonda K Yantiss
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
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Zaiem M, Zaiem F, Zaiem F. Rectal duplication cyst presenting as rectal prolapse in an infant. Journal of Pediatric Surgery Case Reports 2018; 32:49-52. [DOI: 10.1016/j.epsc.2017.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Background and Objectives: Duplications of the alimentary tract are rare anomalies. We report our experience with foregut duplication cysts including their clinical presentation, diagnostic modalities, and surgical management. Methods: We report a 20-year retrospective review of all foregut duplication cysts managed at our institution. Results: Twelve patients with 13 foregut duplication cysts were identified. The ages of the children at the time of surgery ranged from infancy to adolescence, with a mean age of 7.2 years. Half of the patients presented with abdominal pain and vomiting, and the remaining either had respiratory distress or were asymptomatic. All resections were performed electively. Two of the 11 patients had other congenital anomalies, including a congenital pulmonary airway malformation and coarctation of the aorta. One patient had prenatal diagnosis by ultrasonography. Nine patients underwent complete successful excision with no complications. Three patients whose symptoms resolved during hospitalization remained under observation because of parental preference. Conclusions: Foregut malformation in children may present with a variety of symptoms or can be found incidentally. The decision and timing of surgery is based on the clinical presentation. Surgical intervention in asymptomatic patients should be based on a thorough discussion with the parents.
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Affiliation(s)
| | | | - Shilpa Sood
- Department of Pediatrics, Division of Gastroenterology
| | - Natasha Bamji
- Department of Pediatrics, Division of Gastroenterology
| | | | - Gustavo Stringel
- Department of Surgery, Division of Pediatric Surgery, NY Medical College, Maria Fareri Children's Hospital, Valhalla, New York
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20
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Taghavi K, Wilms H, Bann S, Stringer MD. Duodenal duplication cyst causing recurrent pancreatitis. J Paediatr Child Health 2017; 53:814-816. [PMID: 28695671 DOI: 10.1111/jpc.13592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 02/10/2017] [Accepted: 03/14/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Kiarash Taghavi
- Department of Paediatric Surgery, Wellington Children's Hospital, Wellington, New Zealand.,Department of Child Health, University of Otago, Wellington, New Zealand
| | - Heath Wilms
- Department of General Surgery, Nelson Hospital, Nelson, New Zealand
| | - Simon Bann
- Department of General Surgery, Wellington Hospital, Wellington, New Zealand
| | - Mark D Stringer
- Department of Paediatric Surgery, Wellington Children's Hospital, Wellington, New Zealand.,Department of Child Health, University of Otago, Wellington, New Zealand
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21
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Kaushik A, Zauk A. Mediastinal Enteric Cysts With Tracheobronchial Epithelium in a Neonate: A Rare Entity. Pediatr Neonatol 2017; 58:384-5. [PMID: 28385462 DOI: 10.1016/j.pedneo.2016.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/01/2016] [Accepted: 09/26/2016] [Indexed: 11/21/2022] Open
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Abstract
Esophageal duplication and congenital esophageal stenosis (CES) may represent diseases with common embryologic etiologies, namely, faulty tracheoesophageal separation and differentiation. Here, we will re-enforce definitions for these diseases as well as review their embryology, diagnosis, and treatment.
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Affiliation(s)
- A Francois Trappey
- David Grant Medical Center, Travis Air Force Base, California; Division of Trauma, Acute Care Surgery, and Surgical Critical Care, UC Davis Medical Center, Sacramento, California
| | - Shinjiro Hirose
- Department of Surgery, UC Davis Medical Center, Sacramento, California; Division of Pediatric General, Thoracic, and Fetal Surgery, UC Davis Medical Center, Sacramento, California; Shriners Hospitals for Children-Northern California, 2425 Stockton Blvd, Sacramento, California 95817.
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23
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Rattan KN, Bansal S, Dhamija A. Gastrointestinal Duplication Presenting as Neonatal Intestinal Obstruction: An Experience of 15 Years at Tertiary Care Centre. J Neonatal Surg 2017; 6:5. [PMID: 28083491 PMCID: PMC5224762 DOI: 10.21699/jns.v5i4.432] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 09/06/2016] [Indexed: 12/19/2022] Open
Abstract
Background: Gastrointestinal tract (GIT) duplications are one of the rare congenital anomalies and can occur in any portion of the gastrointestinal tract but are more commonly encountered in small intestine. The duplication cysts cause symptoms like abdominal mass and intestinal obstruction requiring surgery or may remain asymptomatic. We are reporting our 15 years’ experience duplication cysts presenting in neonates.
Methods: It is a retrospective study undertaken in the department of pediatric surgery between 2001 and 2015 for GIT duplications in neonates. Patients were analyzed for their antenatal diagnosis, age, sex, clinical diagnosis, investigatory approach, operative management and surgical outcomes.
Results: Total number of neonates, diagnosed with gastrointestinal duplication in the last 15 years, was 17. Male to female ratio was 3.3:1. The most common location was found to be the ileum occurring in 71% of cases. Apart from ileum, 2 cases of duodenal and 1 case each of gastric, colonic and cecal duplication cyst were encountered. Majority cases presented with sub-acute intestinal obstruction and were managed successfully by resection and end to end anastomosis. Associated gut atresia was found in 4 cases while 1 case was found to be associated with perforation of gut.
Conclusion: Gastrointestinal tract duplications often present with typical symptoms of gastrointestinal tract obstruction. Early diagnosis and management is required to prevent postoperative morbidity and mortality.
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Affiliation(s)
- Kamal Nain Rattan
- Department of Pediatric Surgery, Pt. B.D. Sharma PGIMS Rohtak, Haryana
| | - Shruti Bansal
- Department of Pathology, Pt. B.D. Sharma PGIMS Rohtak, Haryana
| | - Aastha Dhamija
- Department of Pathology, Pt. B.D. Sharma PGIMS Rohtak, Haryana
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Endo K, Maeda K, Mishima Y, Tamaki A, Takemoto J, Morita K, Iwade T, Okata Y, Hisamatsu C, Fukuzawa H, Bitoh Y, Akasaka Y, Yokoi A. A case of ileocecal duplication cyst protruding into the intestinal lumen enucleated via an anti-mesenteric approach. Journal of Pediatric Surgery Case Reports 2016; 15:10-13. [DOI: 10.1016/j.epsc.2016.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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25
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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26
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Gurzu S, Bara Jr T, Bara T, Fetyko A, Jung I. Cystic jejunal duplication with Heinrich’s type I ectopic pancreas, incidentally discovered in a patient with pancreatic tail neoplasm. World J Clin Cases 2016; 4:281-284. [PMID: 27672644 PMCID: PMC5018626 DOI: 10.12998/wjcc.v4.i9.281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/03/2016] [Accepted: 07/13/2016] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to present a case of enteric duplication cyst and criteria for a proper differential diagnosis. A 51-year-old male was hospitalized for pancreatic tail neoplasm and distal pancreatectomy with splenectomy was performed. During surgery, a jejunal cystic lesion was incidentally detected and jejunectomy was performed. Microscopically, the cyst was observed to be covered by Keratin 7/Keratin 20 positive intestinal type epithelium and the muscularis layer was shared by the cyst and adjacent jejunum, without a cleavage plane between the cyst wall and jejunal muscularis propria. In the deep muscularis propria, a Heinrich’s type I ectopic pancreas was also noted. In the pancreatic tail, a low grade intraepithelial lesion (panIN-1a) was diagnosed. This case highlights the necessity for a correct differential diagnosis of such rare lesions. Roughly 30 cases of jejunal duplication cysts have been reported to date in the PubMed database.
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Gjeorgjievski M, Manickam P, Ghaith G, Cappell MS. Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts: Case Report and Comprehensive Review of 28 Cases Reported in the Literature. Medicine (Baltimore) 2016; 95:e3799. [PMID: 27258515 PMCID: PMC4900723 DOI: 10.1097/md.0000000000003799] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Analyze efficacy, safety of endoscopic therapy for duodenal duplication cysts (DDC) by comprehensively reviewing case reports.Tandem, independent, systematic, computerized, literature searches were performed via PubMed using medical subject headings or Keywords "cyst" and "duodenal" and "duplication"; or "cyst", and "endoscopy" or "endoscopic", and "therapy" or "decompression"; with reconciliation of generated references by two experts. Case report followed CARE guidelines.Literature review revealed 28 cases (mean = 1.3 ± 1.2 cases/report). Endoscopic therapy is increasingly reported recently (1984-1999: 3 cases, 2000-2015: 25 cases, P = 0.003, OR = 8.33, 95%-CI: 1.77-44.5). Fourteen (54%) of 26 patients were men (unknown-sex = 2). Mean age = 32.2 ± 18.3 years old. Procedure indications: acute pancreatitis-16, abdominal pain-8, jaundice-2, gastrointestinal (GI) obstruction-1, asymptomatic cyst-1. Mean maximal DDC dimension = 3.20 ± 1.53 cm (range, 1-6.5 cm). Endoscopic techniques included cyst puncture via needle knife papillotomy (NKP)/papillotome-18, snare resection of cyst-7, cystotome-2, and cyst needle aspiration/ligation-1. Endoscopic therapy was successful in all cases. Among 24 initially symptomatic patients, all remained asymptomatic post-therapy without relapses (mean follow-up = 36.5 ± 48.6 months, 3 others reported asymptomatic at follow-up of unknown duration; 1 initially asymptomatic patient remained asymptomatic 3 years post-therapy). Two complications occurred: mild intraprocedural duodenal bleeding related to NKP and treated locally endoscopically.A patient is reported who presented with vomiting, 15-kg-weight-loss, and profound dehydration for 1 month from extrinsic compression of duodenum by 14 × 6 cm DDC, underwent successful endosonographic cyst decompression with large fenestration of cyst and endoscopic aspiration of 1 L of fluid from cyst with rapid relief of symptoms. At endoscopy the DDC was intubated and visualized and random endoscopic mucosal biopsies were obtained to help exclude malignant or dysplastic DDC.Study limitations include retrospective literature review, potential reporting bias, limited patient number, variable follow-up.In conclusion, endoscopic therapy for DDC was efficacious in all 29 reported patients including current case, including patients presenting acutely with acute pancreatitis, or GI obstruction. Complications were rare and minor, suggesting that endoscopic therapy may be a useful alternative to surgery for nonmalignant DDC when performed by expert endoscopists.
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Affiliation(s)
- Mihajlo Gjeorgjievski
- From the Division of Gastroenterology & Hepatology, William Beaumont Hospital (MG, PM, GG, MSC); and Oakland University William Beaumont School of Medicine (GG, MSC), Royal Oak, MI
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Sandoval JA, Fernandez-Pineda I, Malkan AD. Risk-reduction surgery in pediatric surgical oncology: A perspective. J Pediatr Surg 2016; 51:675-87. [PMID: 26898681 DOI: 10.1016/j.jpedsurg.2016.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 01/21/2016] [Accepted: 01/21/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE A small percentage of pediatric solid cancers arise as a result of clearly identified inherited predisposition syndromes and nongenetic lesions. Evidence supports preemptive surgery for children with genetic [multiple endocrine neoplasia type 2 (MEN2), familial adenomatous polyposis syndrome (FAP), hereditary nonpolyposis colorectal cancer (HNPCC), and hereditary diffuse gastric cancer (HDGC) and nongenetic [thyroglossal duct cysts (TGDC), congenital pulmonary airway malformations (CPAM), alimentary tract duplication cysts (ATDC), and congenital choledochal cysts (CCC)] developmental anomalies. Our aim was to explore the utility of risk reduction surgery to treat and prevent cancer in children. METHODS A systematic review of the available peer-reviewed literature on PubMed was performed using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) search strategy, where possible. Search items included "risk reduction surgery", "hereditary cancer predisposition syndrome", "multiple endocrine neoplasia type 2", "familial adenomatous polyposis", "hereditary nonpolyposis colorectal cancer", "hereditary diffuse gastric cancer", "thyroglossal duct cysts", congenital pulmonary airway malformations", "alimentary tract duplication cysts", "malignant transformation", and "guidelines". RESULTS We identified 67 articles that met the inclusion criteria describing the indications for prophylactic surgery in surgical oncology. For the genetic predisposition syndromes, 7 studies were related to professional endorsed guidelines, 7 were related to surgery for MEN2, 11 were related to colectomy for FAP, 6 were related to colectomy for HNPCC, and 12 related to gastrectomy for HDGC. Articles for the nongenetic lesions included 5 for techniques related to TGDC resection, 9 for surgery for CPAMs, and 10 for resection of ATDCs. Guidelines and strategies varied significantly especially related to the extent and timing of surgical intervention; the exception was for the timing of thyroidectomy in children with MEN2. CONCLUSION Current evidence supporting prophylactic surgery in the management of pediatric cancer predisposition syndromes and nongenetic lesions is best delineated for thyroidectomy to prevent medullary thyroid cancer in children with MEN2 (Strength of Recommendation Grade B/C). Despite the lack of pediatric specific evidence-based recommendations regarding the appropriate extent and timing for risk-reduction surgery for FAP, HNPCC, HDGC and nongenetic anomalies, our review represents an opportunity towards understanding the postgenomic development of these lesions and provides current indications and techniques for preemptive cancer prevention surgery in children.
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Tjendra Y, Lyapichev K, Henderson J, Rojas CP. Foregut Duplication Cyst of the Stomach: A Case Report and Review of the Literature. Case Rep Pathol 2016; 2016:7318256. [PMID: 26998376 DOI: 10.1155/2016/7318256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/17/2016] [Indexed: 11/18/2022] Open
Abstract
Duplication cyst of the stomach is a rare congenital malformation, typically diagnosed in the first year of life. In most adult cases the cyst remains asymptomatic, but patients may present with abdominal symptoms including epigastric discomfort or pain. We present a case of a 65-year-old male with an asymptomatic gastric tumor diagnosed incidentally during initial workup of his esophageal adenocarcinoma. Computed tomography revealed a low density soft tissue tumor near the gastroesophageal junction. Endoscopic ultrasonography demonstrated a cystic lesion as a hypoechoic round mass with well-defined borders. Following complete laparoscopic resection, microscopic review revealed a cyst lined with respiratory pseudostratified ciliated columnar epithelium and layers of smooth muscle with an outermost thin fibrous capsule consistent with a foregut duplication cyst.
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Jadlowiec CC, Lobel BE, Akolkar N, Bourque MD, Devers TJ, McFadden DW. Presentation and Surgical Management of Duodenal Duplication in Adults. Case Rep Surg 2015; 2015:659150. [PMID: 26844004 DOI: 10.1155/2015/659150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/11/2015] [Accepted: 11/23/2015] [Indexed: 12/11/2022] Open
Abstract
Duodenal duplications in adults are exceedingly rare and their diagnosis remains difficult as symptoms are largely nonspecific. Clinical presentations include pancreatitis, biliary obstruction, gastrointestinal bleeding from ectopic gastric mucosa, and malignancy. A case of duodenal duplication in a 59-year-old female is presented, and her treatment course is reviewed with description of combined surgical and endoscopic approach to repair, along with a review of historic and current recommendations for management. Traditionally, gastrointestinal duplications have been treated with surgical resection; however, for duodenal duplications, the anatomic proximity to the biliopancreatic ampulla makes surgical management challenging. Recently, advances in endoscopy have improved the clinical success of cystic intraluminal duodenal duplications. Despite these advances, surgical resection is still recommended for extraluminal tubular duplications although combined techniques may be necessary for long tubular duplications. For duodenal duplications, a combined approach of partial excision combined with mucosal stripping may offer advantage.
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Kothari M. Tubular duplication of colon and terminal ileum in a female child, case report, review of literature and proposal of a new classification. Journal of Pediatric Surgery Case Reports 2015. [DOI: 10.1016/j.epsc.2015.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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32
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Kim SM, Ha MH, Seo JE, Kim JE, Min BH, Choi MG, Lee JH, Kim KM, Choi DI, Sohn TS, Bae JM, Kim JJ, Kim S, Lee JH. Gastric duplication cysts in adults: a report of three cases. J Gastric Cancer 2015; 15:58-63. [PMID: 25861524 PMCID: PMC4389098 DOI: 10.5230/jgc.2015.15.1.58] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/09/2014] [Accepted: 10/10/2014] [Indexed: 12/31/2022] Open
Abstract
Gastric duplication cyst is a rare congenital anomaly of the gastrointestinal tract and is especially uncommon in adults. Most cases in adults are discovered incidentally on radiological examination or gastric endoscopy. Accurate diagnosis of these cysts before resection is difficult. Differential diagnoses are varied. Malignant transformation of a gastric duplication cyst is very rare. We present three cases of asymptomatic noncommunicating gastric duplication cysts in adults.
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Affiliation(s)
- Su Mi Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Man Ho Ha
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eun Seo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Eun Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Hoon Min
- Department of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min Gew Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Haeng Lee
- Department of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Mi Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Choi
- Department of Diagnostic Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Moon Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Jun Kim
- Department of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Ho Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Patiño Mayer J, Bettolli M. Alimentary tract duplications in newborns and children: Diagnostic aspects and the role of laparoscopic treatment. World J Gastroenterol 2014; 20:14263-14271. [PMID: 25339813 PMCID: PMC4202355 DOI: 10.3748/wjg.v20.i39.14263] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/22/2014] [Accepted: 06/17/2014] [Indexed: 02/06/2023] Open
Abstract
Alimentary tract duplications are rare congenital lesions normally diagnosed in newborns and children that can occur anywhere from the mouth to the anus and have a reported incidence of approximately 1 in 4500 life births. Symptoms and clinical presentation vary greatly. The presentation varies according to age and location. The treatment finally is surgical; total resection when possible should be the aim of the intervention. In pediatric surgery minimally invasive surgical procedures became more and more important over the last decades. In consequence the operative procedure on alimentary tract duplications changed in this manner. We review on case reports and clinical reports on minimally invasive surgery in the treatment of alimentary tract duplications, determine the importance of minimally invasive techniques in the treatment of this rare entity and rule out that further studies in the field should be performed.
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Abstract
Esophageal duplication cyst (EDC) is classified as a subgroup of foregut duplication cyst. They are very rare and predominantly detected in children. We present an unusual cause of wheezing in a 2-month-old infant. The diagnosis of EDC was suspected by bronchoscopy, provisionally confirmed by magnetic resonance imaging, and followed by successful surgical excision of the cyst. We conclude that foregut duplication cyst of the esophagus is very rare, and must be considered in the differential diagnosis of persistent wheezing in infants who do not respond to conventional treatment.
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Affiliation(s)
- Kapil Kapoor
- Department of Pediatrics, Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Mamta Jajoo
- Department of Pediatrics, Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Swati Dublish
- Department of Pediatrics, Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, New Delhi, India
| | - Anup Mohta
- Department of Pediatric Surgery, Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, New Delhi, India
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Cundy TP, Burns EM, Cohen P, Teare J, Darzi A. Duplication cyst of the appendix: a proposal for modification of the Cave-Wallbridge classification. ANZ J Surg 2014; 86:731-2. [PMID: 25041174 DOI: 10.1111/ans.12778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Thomas P Cundy
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Elaine M Burns
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Patrizia Cohen
- Department of Pathology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Julian Teare
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Ara Darzi
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
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Catalano P, Di Pace MR, Caruso AM, De Grazia E, Cimador M. Ileocecal duplication cysts: is the loss of the valve always necessary? J Pediatr Surg 2014; 49:1049-51. [PMID: 24888861 DOI: 10.1016/j.jpedsurg.2013.12.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 11/28/2013] [Accepted: 12/25/2013] [Indexed: 01/14/2023]
Abstract
BACKGROUND Ileocecal (IC) duplication cysts are enteric duplications located at the IC junction, not clearly identified in all the published series. The reported treatment is IC resection and ileocolic anastomosis. It is well known that the loss of the IC valve has several adverse effects. This study is aimed at demonstrating that cyst removal together with the common ileal wall and following enterorrhaphy is possible, safe, and effective in preserving the IC region. METHODS Medical records of 3 patients who underwent surgery for IC duplication between 2003 and 2013 were retrospectively reviewed evaluating follow-up results. RESULTS All patients had an antenatal diagnosis of intraabdominal cystic mass. In two cases associated malformations were reported. The lesions presented at newborn age with intermittent small bowel obstruction and required removal. No patients underwent IC resection. The diagnosis of duplication cyst was confirmed by histo-pathologic examination. The postoperative course was uneventful, even in the long-term follow-up. CONCLUSIONS Our conservative approach is a simple and safe technique, effective in avoiding the loss of the IC valve in children with duplication at the IC junction.
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Affiliation(s)
- Pieralba Catalano
- Pediatric Surgical Unit, Department of Mother and Child Care, University of Palermo, Palermo, Italy.
| | - Maria Rita Di Pace
- Pediatric Surgical Unit, Department of Mother and Child Care, University of Palermo, Palermo, Italy
| | - Anna Maria Caruso
- Pediatric Surgical Unit, Department of Mother and Child Care, University of Palermo, Palermo, Italy
| | - Enrico De Grazia
- Pediatric Surgical Unit, Department of Mother and Child Care, University of Palermo, Palermo, Italy
| | - Marcello Cimador
- Pediatric Surgical Unit, Department of Mother and Child Care, University of Palermo, Palermo, Italy
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Pandey S, Srivastava A, Lal R, Yachha SK, Poddar U. Enteric duplication cysts in children: a target in algorithm for evaluation of lower gastrointestinal bleeding. Indian J Gastroenterol 2014; 33:285-8. [PMID: 24715677 DOI: 10.1007/s12664-014-0445-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 01/22/2014] [Indexed: 02/04/2023]
Abstract
Lower gastrointestinal bleeding (LGIB) in infants and children is a difficult diagnostic problem largely due to limitations of small-bowel evaluation. Duplication cysts are rare congenital malformations with variable clinical presentation. This report describes seven children (five boys, two girls and median age 10 [1.5-124] months) with ileal duplication cysts who presented with LGIB of varying severity from stool occult blood positivity with anemia to fresh bleeding per rectum. Diagnosis was made by Tc(99m) pertechnetate scan (n-5), balloon enteroscopy (n-1), and at laparotomy (n-1). Ultrasonography and barium meal follow-through missed the diagnosis in six and three cases, respectively. All cases underwent surgery with resection of the duplication cyst and complete removal of the mucosa containing ectopic gastric tissue while preserving adequate bowel length. A good postoperative outcome with complete symptom resolution was seen in all. Enteric duplication cyst should always be considered in children presenting with occult or overt lower gastrointestinal hemorrhage, and Tc(99m) pertechnetate scan should be done prior to invasive tests like balloon enteroscopy.
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Affiliation(s)
- Srikant Pandey
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
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Moralioglu S, Pektas OZ, Celayir AC, Bosnali O, Kaygusuz E. Thoracoabdominal duplication symptomatic on both sides: a case report. W INDIAN MED J. 2014;63:192-194. [PMID: 25303260 DOI: 10.7727/wimj.2012.264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/18/2013] [Accepted: 02/14/2013] [Indexed: 12/14/2022]
Abstract
Thoracoabdominal foregut duplications account for less than 2% of all gastrointestinal duplications. Here, we report a case of thoracoabdominal duplication cyst in an eight-month old boy who presented with both respiratory and abdominal complaints. Excision of both thoracic and abdominal extensions of the thoracoabdominal duplications in the same session is an appropriate and safe option to prevent possible complications.
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Affiliation(s)
- Jung Myun Kwak
- Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea
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40
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Abstract
Mediastinal enteric cysts are relatively uncommon, and patients tend to present at a later age compared to those with duplications in other areas of alimentary canal. The tendency of enteric cyst to enlarge and produce airway obstruction is sufficient reason for early surgical removal. We report on a case of mediastinal enteric cyst in a neonate with respiratory distress for its early presentation and management. The embryological basis and anatomical issues relating to duplication cysts of the gastrointestinal tract is discussed.
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Affiliation(s)
- Vikram Singhal
- Department of Pediatrics, Kasturba Medical College, Manipal University, Karnataka, India
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Miyano G, Nakahara Y, Hara K, Hayashi T, Shibuya S, Takahashi T, Nakamura H, Arakawa A, Lane GJ, Okazaki T, Yamataka A. Long intussuscepted colonic duplication. Journal of Pediatric Surgery Case Reports 2013. [DOI: 10.1016/j.epsc.2013.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Sharma P, Singh H, Nazar AH, Srinivas M, Kumar R. 99mTc-pertechnetate SPECT/CT for detecting recurrent foregut duplication cyst in a case with negative planar scintigraphy. Clin Nucl Med 2013; 38:641-2. [PMID: 23486325 DOI: 10.1097/RLU.0b013e318266ceb4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recurrence can occur after incomplete surgical excision of foregut duplication cysts. We here present (99m)Tc-pertechnetate SPECT/CT images of a 3-year-old girl with recurrence of foregut duplication cyst. (99m)Planar Tc-pertechnetate scintigraphy was negative in this case.
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Abstract
A rare case of retroperitoneal gastric duplication is reported and discussed. An intra-abdominal cyst was detected at 31 weeks gestation and was followed up prenatally as a left sided duplex kidney. Post-natal ultrasound however, showed a normal kidney, but a cyst with features of enteric duplication in the left upper quadrant adjacent and compressing the kidney. Surgery was carried out during infancy and a retroperitoneal cyst was excised that contained heterotrophic gastric mucosa.
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Affiliation(s)
- Max Pachl
- Department of Paediatric Surgery, Birmingham Children's Hospital NHS Trust, Steelhouse Lane, Birmingham, B4 6NH, UK
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Costa EC, Ferreira CT, Salle JLP, Fraga JC. Diagnosis and management of congenital rectourethral fistula in a child with long tubular duplication of the colon and Klippel-Feil syndrome. J Pediatr Surg 2011; 46:2184-6. [PMID: 22075355 DOI: 10.1016/j.jpedsurg.2011.08.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 08/26/2011] [Accepted: 08/28/2011] [Indexed: 01/13/2023]
Abstract
We describe a unique association of congenital rectourethral fistula with long tubular duplication of the colon in a boy with Klippel-Feil syndrome and Sprengel deformity. He presented with a rectourethral fistula after surgical repair of a tubular duplication of the terminal ileum, colon, and proximal rectum. Preoperative identification of the fistula was challenging and was only achieved after cystoscopy with injection of methylene blue under pressure through Foley catheters placed into the anus and distal stoma of a colostomy. Surgical repair was performed through the posterior sagittal approach. The patient is doing well after 4 years of follow-up.
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Affiliation(s)
- Eduardo Corrêa Costa
- Department of Pediatric Urology, Pediatric Surgery Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
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Akahane K, Uehara K, Yoshioka Y, Koide F, Ebata T, Yokoyama Y, Igami T, Sugawara G, Takahashi Y, Fukaya M, Itatsu K, Nakamura M, Goto H, Nagino M. Rectal duplication cyst successfully treated by laparoscopic total mesorectal excision using the prolapsing technique. Asian J Endosc Surg 2011; 4:174-7. [PMID: 22776303 DOI: 10.1111/j.1758-5910.2011.00097.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Congenital alimentary tract duplication is a rare disease. It most frequently occurs in the ileum, with the rectum being the rarest site. Herein, we report a 38-year-old woman who was referred to our hospital because of severe anal pain. On digital examination, a smooth, round, rubbery mass was palpable; it was located 5 cm from the anal verge in the posterior rectal wall. A CT scan demonstrated a 5-cm cystic lesion located anterior to the sacrum that was displacing the rectum anteriorly. Spontaneous remission of the tumor was evident; however, after 5 months of follow-up, the patient experienced the same severe anal pain. MRI demonstrated a recurrent cystic lesion. To prevent further complications and to confirm or deny malignancy, laparoscopic total mesorectal excision using the prolapsing technique was performed. Pathologically, the cystic lesion was diagnosed as a rectal duplication cyst. This is the first report of a rectal duplication cyst successfully treated by laparoscopic total mesorectal excision.
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Affiliation(s)
- K Akahane
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Salemis NS, Liatsos C, Kolios M, Gourgiotis S. Recurrent acute pancreatitis secondary to a duodenal duplication cyst in an adult. A case report and literature review. Can J Gastroenterol 2009; 23:749-52. [PMID: 19893770 DOI: 10.1155/2009/979431] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Duodenal duplication cysts are rare congenital abnormalities that are most commonly diagnosed in infancy and childhood. However, in rare cases, the lesion can remain asymptomatic until adulthood. An extremely rare case of a previously healthy adult patient with recurrent acute pancreatitis, who was diagnosed with a duodenal duplication cyst is presented. At laparotomy, a duplication cyst measuring 4.8 cm x 4 cm x 4 cm was found adjacent to the ampulla of Vater. A partial cyst excision and marsupialization into the duodenal lumen was performed. The patient is healthy and asymptomatic four years after surgery. The present case illustrates the necessity of considering a duodenal duplication cyst in the differential diagnosis of recurrent acute pancreatitis in previously healthy adults.
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Abstract
Esophageal duplication cysts are classified as a subgroup of foregut duplication cysts. They are very rare and are predominantly detected in children. Antenatal detection is very rare. We report a case of an esophageal duplication cyst that was accurately identified antenatally by USG and MRI.
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Kashiwagi Y, Suzuki S, Watanabe K, Nishimata S, Kawashima H, Takekuma K, Hoshika A. Sudden unexpected death associated with ileocecal duplication cyst and clinical review. Clin Med Insights Pediatr 2010; 4:25-8. [PMID: 23761993 PMCID: PMC3667037 DOI: 10.4137/cmped.s4850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Duplications of the alimentary tract are very rare. A one-month-old female presented with symptoms of anorexia, vomiting and continuous watery diarrhea. The plain abdominal radiograph showed thickened intestinal wall and signs of small bowel obstruction. The fevers, vomiting, and continuous wartery diarrhea persisted despite antibiotics, and worsened. The patient failed to respond to medical managements, 27 hours after admission, the patient died due to multiple organ failures. The autopsy was performed, small bowel obstruction due to an ileocecal duplication cyst (3 × 3 cm) was recognized. The ileocecal duplication cyst was attached to the ileum which was changed edematous and necrotic. This potential diagnosis should be borne in mind for a patient who complains of abdominal symptoms with an unknown cause, and duplication cyst should be recognized as a fatal cause in infant.
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Affiliation(s)
- Y Kashiwagi
- Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
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Lai CY, Hsu WM, Peng SS, Chou HC, Chen CY, Hsieh WS, Tsao PN. Tubular jejunal duplication, amelia and congenital diaphragmatic eventration in a neonate. Clin Dysmorphol 2010; 19:169-71. [PMID: 20400896 DOI: 10.1097/MCD.0b013e328339ab0c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Tauro LF, George C, Rao BS, Martis JJ, Menezes LT, Shenoy HD. Asymptomatic Meckel's diverticulum in adults: is diverticulectomy indicated? Saudi J Gastroenterol 2010; 16:198-202. [PMID: 20616416 PMCID: PMC3003224 DOI: 10.4103/1319-3767.65199] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Accepted: 01/07/2010] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND/AIM The objective of this study was to estimate the incidence of the Meckel's diverticulum (MD) and to study its clinical profile and surgical outcome, as well as to check whether diverticulectomy is indicated for asymptomatic MD in adults. MATERIALS AND METHODS This is a prospective study of 1332 patients who were operated upon for acute abdomen during the period August 1999 to July 2009 in a single surgical unit. Preoperative abdominal ultrasonography and plain x-ray abdomen (erect) were done depending on the necessity. These patients were subjected to laparotomy/ appendicectomy depending on the case. A search for MD was done, and if found, surgical resection and analysis by histopathological confirmation of the resected MD were performed. RESULTS During the operation, this study detected 15 (1.13%) patients with MD. In none of these cases, preoperative diagnosis of Meckel's diverticulitis was made. The age of the patients ranged from 18 to 68 years (mean age, 32.9 years). Out of 15 patients, 9 (60%) were males; 6 (40%) were females. Seven (46.7%) cases were symptomatic due to MD and 8 (53.3%) were asymptomatic. One patient presented with hematochezia; 2, with intestinal obstruction due to gangrene of the MD; and 4, with Meckel's diverticulitis. One patient had duplication of (double) Meckel's diverticulum without any inflammation in both the diverticulae. Histopathological examination of these specimens confirmed 4 cases with inflammation; 2, with gangrene; and 1, with ulcerated gastric mucosa in the MD. Among these, in 2 (13.3%) cases there was heterotopic epithelium (ulcerated gastric mucosa- 1, colonic mucosa- 1). CONCLUSION We recommend that a search for MD in every case of appendicectomy/ laparotomy done for acute abdomen should be conducted, and if found, Meckel's diverticulectomy or resection should be performed to avoid secondary complications arising from it.
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Affiliation(s)
- Leo F. Tauro
- Department of General Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore (D.K.), Karnataka, India
| | - Celine George
- Department of General Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore (D.K.), Karnataka, India
| | - Bangalore S. Rao
- Department of General Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore (D.K.), Karnataka, India
| | - John J. Martis
- Department of General Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore (D.K.), Karnataka, India
| | - Leo T. Menezes
- Department of General Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore (D.K.), Karnataka, India
| | - Hejmadi D. Shenoy
- Department of General Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore (D.K.), Karnataka, India
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