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Yoshikawa C, Migita K, Yamato I, Ueno M, Kashizuka H, Murakami K, Ishikawa H. Acute peritonitis caused by the acute pancreatitis of an ectopic pancreas in a jejunal duplication, in an adult with intestinal malrotation: a case report. Surg Case Rep 2023; 9:150. [PMID: 37638994 PMCID: PMC10462583 DOI: 10.1186/s40792-023-01736-2] [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: 06/20/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Intestinal duplication and ectopic pancreas are two rare independent congenital anomalies. Few reports describe cases of patients with ectopic pancreas in an intestinal duplication causing acute peritonitis. CASE PRESENTATION A 31-year-old man was admitted to the hospital for epigastric pain. The patient was diagnosed with acute peritonitis caused by the acute pancreatitis of an ectopic pancreas in a jejunal duplication, with intestinal malrotation. The patient underwent the partial resection of the jejunum and Ladd's procedure. The histopathological findings indicated ectopic pancreatitis in the jejunal duplication. CONCLUSIONS We presented the case of acute peritonitis caused by the acute pancreatitis of an ectopic pancreas in a jejunal duplication in an adult with intestinal malrotation. Surgery is the primary treatment and is necessary for a definitive diagnosis.
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Affiliation(s)
- Chihiro Yoshikawa
- Department of Surgery, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro Sango-Cho Ikoma-Gun, Nara, 636-0802, Japan.
| | - Kazuhiro Migita
- Department of Surgery, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro Sango-Cho Ikoma-Gun, Nara, 636-0802, Japan
| | - Ichiro Yamato
- Department of Surgery, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro Sango-Cho Ikoma-Gun, Nara, 636-0802, Japan
| | - Masato Ueno
- Department of Surgery, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro Sango-Cho Ikoma-Gun, Nara, 636-0802, Japan
| | - Hisanori Kashizuka
- Department of Surgery, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro Sango-Cho Ikoma-Gun, Nara, 636-0802, Japan
| | - Koichi Murakami
- Department of Surgery, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro Sango-Cho Ikoma-Gun, Nara, 636-0802, Japan
| | - Hirofumi Ishikawa
- Department of Surgery, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro Sango-Cho Ikoma-Gun, Nara, 636-0802, Japan
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Higashidate N, Sakamoto S, Saikusa N, Koga Y, Masui D, Nakahara H, Nakamura M, Saikusa M, Kinoshita M, Kaji T. Tubular intestinal duplication extending from the stomach to the ileum associated with multiple intestinal atresia and situs inversus: a case report. Surg Case Rep 2023; 9:141. [PMID: 37556040 PMCID: PMC10412515 DOI: 10.1186/s40792-023-01728-2] [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: 07/03/2023] [Accepted: 08/06/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Duplication of the alimentary tract can occur in any of its parts. For duodenal duplication, complete resection is particularly difficult when the ampulla of Vater is on the duplicated lumen and a deliberate management is necessary. CASE PRESENTATION A 0-day female baby was referred to our department due to abdominal distention. The X-ray examination showed dextrocardia and opacity of the liver on the left side and abdominal ultrasonogram revealed remarkable intestinal dilatation. Therefore, urgent laparotomy was performed on the day of birth. Complete situs inversus of the abdominal organs was revealed, and the origin of the jejunum was on the left side and was accompanied by tubular intestinal duplication. The origin of the duplicated intestine was at the pancreatic head's dorsal area. There were two points of type Шa atresia on the ileum. Therefore, we spared the duplicated intestine with a length of 3 cm to secure the passage of the biliary and pancreatic juices by a functional-side-to-side anastomosis with a 45-mm Endo-GIA™ camel load (Medtronic, Minneapolis, MN, USA). The ileum was transected at the distal side of the atresia point, and end-to-end jejunoileostomy was performed. Postoperative gastrointestinal series revealed remnants of the duplicated alimentary tract on the dorsal area of the stomach. CONCLUSIONS Identifying the position of the ampulla of Vater is crucial in the surgery of alimentary tract duplication with duodenal involvement. However, in the present case, it was difficult to identify whether the ampulla of Vater was on the true or duplicated lumen, and we had to spare the duplicated duodenum. Stapler anastomosis could be performed safely even in neonatal cases.
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Affiliation(s)
- Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Misa Nakamura
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Mamoru Saikusa
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Masahiro Kinoshita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Tatsuru Kaji
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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Xiong PF, Yang L, Mou ZQ, Jiang Y, Li J, Ye MX. Giant teratoma with isolated intestinal duplication in adult: A case report and review of literature. World J Gastrointest Surg 2023; 15:978-983. [PMID: 37342858 PMCID: PMC10277953 DOI: 10.4240/wjgs.v15.i5.978] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/09/2023] [Accepted: 04/07/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND A combination of diseases is a rare phenomenon. Their clinical manifestations can vary, and the diagnosis can be challenging. Intestinal duplication is a rare congenital malformation, whereas retroperitoneal teratoma is a tumor in the retroperitoneal space, derived from the remaining embryonic tissue. There are relatively few clinical findings on adult retroperitoneal benign tumors. It is hard to believe that these two rare diseases can happen to the same person.
CASE SUMMARY A 19-year-old woman complaining of abdominal pain with nausea and vomiting was admitted. Abdominal computed tomography angiography was suggested for invasive teratoma. Intraoperative exploration revealed that the giant teratoma was connected to an isolated intestinal tract in the retroperitoneum. The postoperative pathological examination revealed that mature giant teratoma was present with intestinal duplication. This was a rare intraoperative finding that was successfully treated surgically.
CONCLUSION The clinical manifestations of intestinal duplication malformation are various, and difficult to diagnose before the operation. The possibility of intestinal replication should be considered when intraperitoneal cystic lesions are present.
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Affiliation(s)
- Ping-Fu Xiong
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Li Yang
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Zhi-Qiang Mou
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Yu Jiang
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Jing Li
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Ming-Xin Ye
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
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Matsukubo M, Muto M, Kedoin C, Matsui M, Murakami M, Sugita K, Yano K, Onishi S, Harumatsu T, Yamada K, Yamada W, Kaji T, Ieiri S. An unusual presentation of intestinal duplication mimicking torsion of Meckel's diverticulum: a rare report of a pediatric case. Surg Case Rep 2022; 8:53. [PMID: 35344094 PMCID: PMC8960505 DOI: 10.1186/s40792-022-01409-6] [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: 02/02/2022] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Enteric duplication is a congenital disease that occurs throughout the entire gastrointestinal tract. Although it may sometimes cause intestinal volvulus, a few reports have described cases of enteric duplication twisted on itself. We experienced a rare pediatric case of long-segment tubular ileal duplication showing torsion. Torsion of enteric duplication is extremely rare. We herein report a pediatric case showing unusual torsion of ileal duplication requiring emergency surgery. Case presentation A 3-year-old boy presented with abdominal pain and vomiting. Contrast-enhanced computed tomography (CT) revealed a cystic luminal structure with a blind end and fluid collection in the pelvic cavity. CT also showed no findings of ileus or intestinal dilatation except for a cystic luminal structure. The preoperative diagnosis was torsion of Meckel’s diverticulum. The patient underwent emergent explorative diagnostic laparoscopy. As a result, a necrotic luminal structure and bloody ascites were recognized, and small-scale laparotomy was performed. Long-segment ileal duplication was recognized. The long-segment tubular ileal duplication shared the anti-mesenteric side of the intestinal wall along one-third of its length. The residual two-thirds of its length was free from the ileum and its blind end was twisted in a manner that looked similar to Meckel’s diverticulum. Normal ileum and the duplication, including the twisted necrotic portion, were resected, and ileal anastomosis was performed. The postoperative course was uneventful. A pathological examination confirmed the definitive diagnosis of enteric duplication. Conclusions We reported the unusual presentation of intestinal duplication mimicking torsion of Meckel’s diverticulum. Enteric duplication shows various clinical symptoms and presentations. We must understand that the classification of digestive enteric duplication is diverse with a variety of associated clinical symptoms.
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Affiliation(s)
- Makoto Matsukubo
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Mitsuru Muto
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Chihiro Kedoin
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Mayu Matsui
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Masakazu Murakami
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Koshiro Sugita
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Keisuke Yano
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Shun Onishi
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Toshio Harumatsu
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Koji Yamada
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan
| | - Waka Yamada
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan.,Clinical Training Center, Kagoshima University Hospital, Kagoshima, Japan
| | - Tatsuru Kaji
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Satoshi Ieiri
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 8908520, Japan.
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Wang TL, Gong XS, Wang J, Long CY. Intestinal intussusception caused by intestinal duplication and ectopic pancreas: A case report and review of literature. World J Clin Cases 2022; 10:2261-2267. [PMID: 35321161 PMCID: PMC8895165 DOI: 10.12998/wjcc.v10.i7.2261] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/17/2021] [Accepted: 01/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Intestinal intussusception caused by intestinal duplication and ectopic pancreas is extremely rare in the clinic and has not been reported previously.
CASE SUMMARY A 29-year-old man was admitted to the hospital for chronic abdominal pain and bloating. The preoperative diagnosis was intestinal obstruction and intussusception. Then, laparotomy, partial small intestinal resection and extraintestinal decompression were performed. Postoperative pathology confirmed intestinal duplication and ectopic pancreas. After surgery, the patient recovered well with no complications. No recurrence was observed after more than 5 mo of follow-up.
CONCLUSION We report a new case of a young male with intussusception caused by intestinal duplication and ectopic pancreas. Surgery is the main treatment for these conditions. This study aimed to raise awareness and provide information to improve the clinical management of this rare yet serious condition.
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Affiliation(s)
- Tao-Li Wang
- Department of Pathology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan Province, China
| | - Xiao-Song Gong
- The Second Department of General Surgery, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan Province, China
| | - Jin Wang
- The Second Department of General Surgery, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan Province, China
| | - Chen-Yan Long
- The Second Department of General Surgery, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, Hunan Province, China
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Grande Moreillo C, Margarit Mallol J, Fuentes Carretero S. Intestinal duplication isolated from the digestive tract: an entity to be considered. Cir Pediatr 2022; 35:36-41. [PMID: 35037439 DOI: 10.54847/cp.2022.01.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To review intestinal duplications isolated from the digestive tract. MATERIAL AND METHODS Description of the 27 isolated intestinal duplication cases published; presentation of a new case. RESULTS Intestinal duplication isolated from the digestive tract represents an extremely rare malformation. This type of duplication is not in close contact with any segment of the intestinal tract, and it has its own vascular pedicle. Preoperative diagnosis rates are lower than those found in classic duplications. In addition to the potential complications, malformation torsion is also to be considered. CONCLUSIONS This infrequent variant is to be considered at differential diagnosis. Potential torsion should also be taken into account in order to decide when an asymptomatic patient should undergo surgery.
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Affiliation(s)
- C Grande Moreillo
- Pediatric Surgery Department. Mútua de Terrassa University Hospital. Terrassa, Barcelona (Spain)
| | - J Margarit Mallol
- Pediatric Surgery Department. Mútua de Terrassa University Hospital. Terrassa, Barcelona (Spain)
| | - S Fuentes Carretero
- Pediatric Surgery Department. Mútua de Terrassa University Hospital. Terrassa, Barcelona (Spain)
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7
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Han XD, Zhou N, Lu YY, Xu HB, Guo J, Liang L. Pseudomyxoma peritonei originating from intestinal duplication: A case report and review of the literature. World J Clin Cases 2021; 9:7459-7467. [PMID: 34616812 PMCID: PMC8464479 DOI: 10.12998/wjcc.v9.i25.7459] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/08/2021] [Accepted: 07/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pseudomyxoma peritonei (PMP) is a rare mucinous neoplasm with a relatively low incidence of 1 to 2 per million individuals. It is typically characterized by a type of gelatinous ascites named “jelly belly”. Most cases of PMP occur in association with ruptured primary mucinous tumors of the appendix (90%). Periodically, PMP can originate from mucinous carcinomas at other sites, including the colorectum, gallbladder, and pancreas. However, unusual origin can occur, as noted in this case report.
CASE SUMMARY A 52-year-old woman had an unusual derivation of PMP from intestinal duplication. The patient complained of abdominal distension and increasing abdominal girth. Abdominal contrast-enhanced computed tomography showed a mass in the greater omentum located on the left side of the abdomen, likely to be a cystic mass of peritoneal origin. A PMP diagnosis was presumed based on the specific signs of the mass with flocculent and stripe-like echoes in ultrasound images. Ultrasound-guided percutaneous aspiration suggested a high likelihood of PMP. Once the PMP diagnosis was recognized, identification of the origin of the primary tumor was indicated. Thus, an exploratory laparoscopy was performed. In the absence of a primary tumor of appendix origin, the diagnosis of a low-grade mucinous neoplasm of intestinal duplication origin was finally confirmed by histopathology.
CONCLUSION PMP is secondary to mucinous carcinomas of the appendix mostly. This case resulted from an unusual derivation from intestinal duplication.
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Affiliation(s)
- Xue-Di Han
- Department of Ultrasound, Aerospace Center Hospital, Beijing 100049, China
| | - Nan Zhou
- Department of Ultrasound, Aerospace Center Hospital, Beijing 100049, China
| | - Yi-Yan Lu
- Department of Pathology, Aerospace Center Hospital, Beijing 100049, China
| | - Hong-Bin Xu
- Department of Myxoma, Aerospace Center Hospital, Beijing 100049, China
| | - Jun Guo
- Department of Ultrasound, Aerospace Center Hospital, Beijing 100049, China
| | - Lei Liang
- Department of Ultrasound, Aerospace Center Hospital, Beijing 100049, China
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Fukazawa H, Kajihara K, Kuroda Y, Fujieda Y, Uemura K, Takeuchi Y, Samejima Y, Kawahara I, Morita K, Iwade T, Maeda K. Two infant cases of intraperitoneal arterial hemorrhage due to a duplication cyst: a case report. Surg Case Rep 2020; 6:55. [PMID: 32200428 PMCID: PMC7085490 DOI: 10.1186/s40792-020-00820-1] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background Intraperitoneal arterial hemorrhage without trauma is extremely rare. We report two infant cases of intraperitoneal arterial hemorrhage due to intestinal duplication. Case presentation In case 1, a 2-month-old girl experienced sudden intraperitoneal hemorrhage from the middle colic artery with no apparent trauma. Hemostasis was achieved with suturing of the hemorrhage point, but the cause of hemorrhage was still unknown. Computed tomography after the first operation revealed a duodenal duplication cyst and a pseudopancreatic cyst. Percutaneous drainage of the pseudopancreatic cyst was performed, and the contents had high pancreatic amylase. As the size of the duodenal duplication cyst also decreased with this drainage, we suspected that the duodenal duplication cyst was connected to the pseudopancreatic cyst and the arterial hemorrhage. We hypothesized that the pancreatic juice inside the duplication cyst leaked into the intraperitoneal cavity and caused rupture of the arterial wall. Therefore, marsupialization of the duodenal duplication was performed to evacuate the pancreatic juice contained in the cyst toward the native duodenum. The postoperative course was uneventful. In case 2, a 6-month-old boy experienced sudden intraperitoneal hemorrhage without trauma. The hemorrhage site was identified as the ileocecal artery, and hemostasis was achieved with sutures. Tissue near the hemorrhage point was biopsied, because the cause of arterial wall rupture was still unknown. The biopsied tissue was found to be intestinal mucosa. The patient had recurrent abdominal pain after the first operation, and computed tomography showed a duplication cyst located near the hemorrhage point. Therefore, we resected the intestinal duplication. Pathology results showed that the intestinal duplication contained intestinal mucosa, ectopic gastric mucosa, and pancreatic tissue. The postoperative course was uneventful. Conclusion Intraperitoneal arterial hemorrhage without trauma is an extremely rare condition, and identifying its cause is difficult. To our knowledge, this is the first report of intraperitoneal arterial hemorrhage due to intestinal duplication. In cases of unexplained intraperitoneal arterial hemorrhage in infants, intestinal duplication near the hemorrhage point should be suspected.
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Affiliation(s)
- Hiroaki Fukazawa
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. .,Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan.
| | - Keisuke Kajihara
- Department of Pediatric Surgery, Kyusyu University, Fukuoka, Japan
| | - Yasuhiro Kuroda
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
| | - Yuki Fujieda
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
| | - Kotaro Uemura
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
| | - Yuki Takeuchi
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
| | - Yoshitomo Samejima
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
| | - Insu Kawahara
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
| | - Keiichi Morita
- Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
| | - Tamaki Iwade
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
| | - Kosaku Maeda
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7 Minatojima-minami, Chuo-ku, Kobe, 650-0047, Japan
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9
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Azzam A, Abdulkarim AN, Shehata AEM, Mahran I, Arafa A, Arafat A, Tawfik S, Shaban M, Anache A, Kaddah S, Taher H. A report of two infant cases operated for jejunal duplication cyst associated with malrotation and volvulus. Int J Surg Case Rep 2020; 67:227-230. [PMID: 32113129 PMCID: PMC7047138 DOI: 10.1016/j.ijscr.2020.02.009] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 11/16/2022] Open
Abstract
THE COMBINATION OF Enteric duplication and intestinal malrotation IS rare but can coexist. Malrotation MUST BE kept in mind in patients with preoperatively diagnosed duplication cyst. Surgical correction in form of A LADD's procedure and resection of THE duplication WITH anastomosis IS CURATIVE. Ultrasound seems TO BE a good diagnostic tool for THE PREOPERATIVE diagnosis of both conditions.
Introduction Both Enteric duplication and intestinal malrotation are concerning causes for intestinal obstruction in the pediatric age group and they very rarely coexist in the same patient. Presentation of cases We present 2 cases of previously healthy children, the first is a 4-month-old infant and the second is a 1.5-year-old boy, both presented with recurrent attacks of bilious vomiting that proved to be due to acute midgut volvulus caused by an enteric duplication cyst associated with intestinal malrotation. Discussion Enteric duplication and intestinal malrotation are two of the concerning causes of billious vomiting in the pediatric age group. They could be encountered at any level of the alimentary tract from the tongue to the anus. The term malrotation refers to all abnormalities of intestinal position. The coincidence of intestinal malrotation and an enteric duplication cyst (EDC) is very rare and has been described only in a few case reports. Conclusion The concomitance of EDC and intestinal malrotation is extremely rare and should be kept in mind in a child presenting with bilious vomiting especially in a child preoperatively diagnosed with a duplication cyst.
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Affiliation(s)
- Ahmed Azzam
- Pediatric Surgery Department, Cairo University, Egypt
| | | | | | | | - Ahmed Arafa
- Pediatric Surgery Department, Cairo University, Egypt
| | - Ahmed Arafat
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Muayad Shaban
- Pediatric Surgery Department, Cairo University, Egypt
| | - Aliyu Anache
- Umar Yar'Adua Maternal and Children Hospital Katsina, Nigeria
| | - Sherif Kaddah
- Pediatric Surgery Department, Cairo University, Egypt
| | - Heba Taher
- Pediatric Surgery Department, Cairo University, Egypt.
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Ricciardolo AA, Iaquinta T, Tarantini A, Sforza N, Mosca D, Serra F, Cabry F, Gelmini R. A rare case of acute abdomen in the adult: The intestinal duplication cyst. case report and review of the literature. Ann Med Surg (Lond) 2019; 40:18-21. [PMID: 30962926 PMCID: PMC6426707 DOI: 10.1016/j.amsu.2019.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 02/19/2019] [Accepted: 03/05/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Duplications of the gastrointestinal tract are rare congenital anomalies that can occur anywhere throughout the gastrointestinal tract. The reported incidence is 1/4500, and more than 80% occurs before the age of two as an acute abdomen or bowel obstruction. The most common site is Ileum (60%), while the colonic localisation is reported between 4 and 18%. PRESENTATION OF THE CASE Herein we report the case of a 35-year-old man, presented at the Emergency Department with fever and localised abdominal pain in the right iliac fossa. Preoperative abdominal ultrasound and CT scan showed a cystic mass of 44 × 43 × 70 mm adjoining the posterior wall of the right colon. He underwent explorative laparoscopy, laparotomy conversion, right hemicolectomy with an intra-operative diagnosis of colonic duplication cyst, confirmed by histology. DISCUSSION The review of the literature showed as the intestinal duplication cysts are rare congenital anomalies. The clinical presentation is variable and depends on the site and the related complications. A surgical approach based on the resection of the involved bowel tract is the treatment associated with the best long-term outcomes. CONCLUSION It is important to include intestinal duplication in the differential diagnosis of acute abdomen, to ensure the best therapeutic strategy.
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Affiliation(s)
| | | | | | | | | | | | | | - Roberta Gelmini
- Department of Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Via del Pozzo, 71 41100, Modena, Italy
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Kimura S, Iida H, Gunji N, Gohongi T, Ogata T. Stool filling of an intestinal duplication cyst at the ileocecal valve triggers colonic intussusception: a case report. Surg Case Rep 2018; 4:116. [PMID: 30219978 PMCID: PMC6139107 DOI: 10.1186/s40792-018-0527-z] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/10/2018] [Indexed: 02/04/2023] Open
Abstract
Background Intestinal duplication, a congenital malformation, is considered a rare condition, particularly in adults. Although it affects young children, a minority of patients remains asymptomatic until adulthood. Here, we describe a case of an intestinal duplication cyst that caused intussusception by a unique mechanism. Case presentation A 19-year-old man was admitted to our hospital for intermittent abdominal pain. Computed tomography revealed colonic intussusception induced by a nodular mass in the ileocecal region. Urgent ileocecal resection was performed because of the risk of colonic ischemia. The resected material comprised a stool-filled noncommunicating cyst that protruded into the enteric lumen at the ileocecal valve. Histological analyses revealed that the inner wall of the cyst was lined with colonic mucosa and that the muscle layer of the cyst was shared with that of the original enteric wall; furthermore, the cyst had a vestige of an opening site in the wall. We concluded that the cyst was an intestinal duplication that poured stool into its lumen through the tiny orifice, thereby triggering intussusception. Conclusions The present case suggests that stool-pouring can cause intussusception into the space of an intestinal duplication lesion.
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Affiliation(s)
- Sota Kimura
- Department of Surgery, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki, 305-0854, Japan.
| | - Hiroyuki Iida
- Department of Surgery, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki, 305-0854, Japan
| | - Naoto Gunji
- Department of Surgery, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki, 305-0854, Japan
| | - Takeshi Gohongi
- Department of Surgery, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki, 305-0854, Japan
| | - Takesaburo Ogata
- Department of Pathology, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki, 305-0854, Japan
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12
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Wang Y, Wu Y, Guan W, Yan W, Li Y, Fang J, Wang J. Meconium peritonitis due to fetal appendiceal perforation: two case reports and a brief review of the literature. BMC Pediatr 2018; 18:162. [PMID: 29751786 PMCID: PMC5948796 DOI: 10.1186/s12887-018-1133-8] [Citation(s) in RCA: 6] [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: 03/23/2017] [Accepted: 04/30/2018] [Indexed: 12/01/2022] Open
Abstract
Background Meconium peritonitis is an infrequent congenital disease usually caused by perforation of the fetal digestive tract. Meconium peritonitis resulting from intrauterine appendiceal perforation has been rarely reported and is often overlooked during pregnancy. We herein report two cases of fetal appendiceal perforation. Case presentation Two neonates were found to have intestinal distension and gradually increasing ascites antenatally. After birth, diagnostic abdominal punctures revealed meconium peritonitis. Urgent surgery showed both neonates had developed gangrenous appendicitis in utero. Pathological examination supported the diagnosis of fetal appendiceal perforation in both neonates, and one also had deformity of cecal duplication. In the present report, we also review the presentation, diagnosis, pathology, management, and recent literature of fetal appendiceal perforation. Conclusion Meconium peritonitis due to fetal appendiceal perforation is extremely rare, and preoperative diagnosis is almost impossible. However, clinicians should be aware of abnormal gastrointestinal manifestations in the fetus during the antenatal examination. For neonates with severe meconium peritonitis, an early operation with careful intraoperative exploration is necessary.
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Affiliation(s)
- Yi Wang
- Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, No 1665, Kongjiang Road, Shanghai, 200092, People's Republic of China
| | - Yeming Wu
- Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, No 1665, Kongjiang Road, Shanghai, 200092, People's Republic of China
| | - Wenbin Guan
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China
| | - Wenbo Yan
- Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, No 1665, Kongjiang Road, Shanghai, 200092, People's Republic of China
| | - Yuhua Li
- Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China
| | - Jin Fang
- Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China
| | - Jun Wang
- Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, No 1665, Kongjiang Road, Shanghai, 200092, People's Republic of China.
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Cárdenas Elias MA, Vázaquez Rueda F, Betancourth-Alvarenga JE, Centeno Haro M, Murcia Pascual FJ, Paredes Esteban RM. [ Intestinal duplication, a single experiencie center]. Cir Pediatr 2016; 29:54-57. [PMID: 28139103] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOUSE Intestinal duplications (DI) are rare congenital anomalies (1/10.000 new born). We analyze the clinical characteristics, management and treatment of intestinal duplications in our center. MATERIALS AND METHODS We perform a retrospectively descriptive analysis review by the DI confirmed by histological studies since 1993-2014 in our center. The variables analyzed are: age, sex, clinical presentation, localization, anatomical type, associated diseases, heterotopic tissue, treatment and complications. RESULTS We found ten patients diagnosed with DI. 60% were male, the middle age was 2.72 years (12 days-7 years). In the clinical presentation 30% presents acute abdomen, another 30% gastrointestinal bleeding and 30% were prenatal diagnosed. Imaging studies were echography, gammagraphy, magnetic resonance imaging and intestinal transit contrast. The most frequent localization was the yeyuno-ileal (60%) with cystic predominance; the gastric, duodenal colic was 10% respectively; an ectopic localization was a suprarenal mass. The treatment was a complete resection by laparotomy in eight cases and laparoscopic in two In the duodenal duplication, we perform a partial resection and mucosectomy. In 60% was necessary the intestinal resection. In anatomy pathologic results, gastric tissue (heterotopic tissue) was present in 70% and pancreatic tissue in 10%. We report an intussusception postsurgical as a complication. CONCLUSIONS The preoperative diagnosis is rare, although prenatal diagnosis is increasing. Clinical manifestations are associated with the location of the DI and the existence of heterotopic gastric mucosa. Laparoscopy is currently the treatment of choice in uncomplicated cases.
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Affiliation(s)
| | - F Vázaquez Rueda
- UGC de Cirugía Pediátrica. Hospital Universitario Reina Sofía. Córdoba
| | | | - M Centeno Haro
- UGC de Cirugía Pediátrica. Hospital Universitario Reina Sofía. Córdoba
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Bellanova G, Valduga P, Costa A, Barbareschi M, De Carli N, Giannelli G, Di Sipio A, Prezzi C, Ciarleglio FA, Beltempo P, Marcucci S, Giacomin D, Depretis G, Brolese A. Double intestinal duplication and incidental neuroendocrine tumor of appendix, a rare case of acute abdomen. Int J Surg Case Rep 2015; 13:116-8. [PMID: 26188982 PMCID: PMC4529655 DOI: 10.1016/j.ijscr.2015.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 03/30/2015] [Revised: 06/13/2015] [Accepted: 06/19/2015] [Indexed: 01/26/2023] Open
Abstract
We present a rare case of double intestinal duplication and incidental neuroendocrine tumor of appendix like acute abdomen. We discuss about the difficult in diagnostic imaging. We consider surgery mandatory for diagnosis and definitive therapy in these cases.
Introduction Intestinal duplication is rarely reported in adulthood and often remains undiagnosed until onset of complications. We describe the case of a 39 year old woman who came to our observation for acute abdomen due to a combination of double intestinal duplication (colon and ileum) and an incidental neuroendocrine tumor of the appendix. Materials and methods A 39 year old woman who was admitted at with upper abdominal pain. Multisliced spiral CT scan showed a cystic lesion suggestive of an inflammed Meckel’s diverticulum.The patient was underwent an urgent explorative laparoscopy. The intraoperative findings revealed a cystic lesion of the anti-mesenteric side of transverse colon, apparently dissectable from the bowel and a second lesion with a strongly adherent and unresectable from the anti-mesenteric aspect of the small bowel. A combined appendectomy was also performed. The histological diagnosis was consistent with a typical intestinal duplication for both intestinal lesionsand an incidental 2 mm carcinoid tumor was also found in the appendix. The postoperative course was uneventful and the patient was discharged on p.o. day 5. At the presenttime she is well and following a regular oncologic follow-up. Discussion The rarity of this case is due to the concomitant presence of an incidental, sincronous, appendiceal NET. The elective treatment is surgical resection. Conclusion Intestinal duplication in the adulthood is extremely rare and may either have an acute presentation as acute abdomen or represents an incidental finding of mass. We suggest that, once the diagnosis is suspected patient must undergo surgery.
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Affiliation(s)
- G Bellanova
- General Surgery and HBP unit Pathology Surgery, S. Chiara Hospital, Trento, Italy.
| | - P Valduga
- General Surgery and HBP unit Pathology Surgery, S. Chiara Hospital, Trento, Italy
| | - A Costa
- Emergency Department, S. Chiara Hospital,Trento, Italy
| | | | - N De Carli
- Pathology Unit, S. Chiara Hospital, Trento, Italy
| | - G Giannelli
- Radiology Department, S. Chiara Hospital,Trento, Italy
| | - A Di Sipio
- General Surgery and HBP unit Pathology Surgery, S. Chiara Hospital, Trento, Italy
| | - C Prezzi
- General Surgery and HBP unit Pathology Surgery, S. Chiara Hospital, Trento, Italy
| | - F A Ciarleglio
- General Surgery and HBP unit Pathology Surgery, S. Chiara Hospital, Trento, Italy
| | - P Beltempo
- General Surgery and HBP unit Pathology Surgery, S. Chiara Hospital, Trento, Italy
| | - S Marcucci
- General Surgery and HBP unit Pathology Surgery, S. Chiara Hospital, Trento, Italy
| | - D Giacomin
- Gastroenterology Unit, S. Chiara Hospital, Trento, Italy
| | - G Depretis
- Gastroenterology Unit, S. Chiara Hospital, Trento, Italy
| | - A Brolese
- General Surgery and HBP unit Pathology Surgery, S. Chiara Hospital, Trento, Italy
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Ekbote G, Pokharkar AB, Moon P. A rare case of perforated tubular ileal duplication in 72-year-old male. Indian J Surg 2012; 75:418-20. [PMID: 24426635 DOI: 10.1007/s12262-012-0749-4] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 09/11/2012] [Indexed: 12/31/2022] Open
Abstract
Enteric duplication is a rare anomaly, which is common in pediatric population, and it is very rare in adults. Enteric duplication can occur anywhere from mouth to anus. Ileal duplication is the most common (30 %) followed by duodenum, stomach, jejunum, colon and rectum. Though most cases are presented within the first 2 years of life, some may present at later age. Here we report a case of a 72-year-old male presented to us in emergency as acute abdomen, which was presumptively diagnosed as ca rectosigmoid, but later the patient developed perforative peritonitis. On exploratory laparotomy he was diagnosed as a case of perforated ileal duplication cyst. Though these lesions are very rare, the importance of enteric duplication cysts lies in the fact that they can mimic many disease conditions and may be left untreated.
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Fiorani C, Scaramuzzo R, Lazzaro A, Biancone L, Palmieri G, Gaspari AL, Sica G. Intestinal duplication in adulthood: A rare entity, difficult to diagnose. World J Gastrointest Surg 2011; 3:128-30. [PMID: 22007281 PMCID: PMC3192219 DOI: 10.4240/wjgs.v3.i8.128] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 06/06/2011] [Accepted: 06/15/2011] [Indexed: 02/06/2023] Open
Abstract
Duplications of the alimentary tract (ATD) are rare congenital anomalies often found early in life. They may occur anywhere in the intestinal tract but the ileum is the most frequently affected site. Clinical presentation of ATD in adults is variable and because these lesions occur so infrequently they are rarely suspected. In the present report we describe a case of ileal duplication in a 61-year-old patient with Crohn’s disease. Despite various radiological investigations and medical consultations, the diagnosis was only made on the surgical specimen.
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Affiliation(s)
- Cristina Fiorani
- Cristina Fiorani, Rosa Scaramuzzo, Alessandra Lazzaro, Achille L Gaspari, Giuseppe Sica, Department of Surgical Science, Tor Vergata University Hospital, 00133 Rome, Italy
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Abstract
Gastrointestinal duplications are rare but interesting clinical entities. They have a varied presentation, with most of them showing up in paediatric population. Clinical features may vary from asymptomatic abdominal masses to bowel obstruction or perforation. This review traces the embryological origin and describes the anatomical types of duplications. An outline of the principles of management is described.
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Affiliation(s)
- H K Ramakrishna
- Lakshmi Surgical and Endoscopic Unit, New Brdige Road, Bhadravati, 577 301 India
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Abstract
Duplications of the alimentary tract are uncommon congenital malformations that can present diagnostic difficulties. We report a rare case of a cystic colonic duplication in a female adult. Preoperative investigations were suggestive of pancreatic tumor. The diagnosis was established based on the histopathological examination of the resected specimen. We concluded that, though uncommon, intestinal duplication should be considered in differential diagnosis of abdominal mass.
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