1078 Enteric Duplication Cyst in An Adult: Presenting with Diarrhea and Vomiting

Abstract

Abstract Intestinal duplication cysts are rare disease entirety, most commonly presenting in childhood. The incidence is 1:4,500 births, with a slight male predominance. They can occur anywhere along the alimentary tract, 35% occur in the ileum and 10% in jejunum. Diagnosis can prove challenging as they can present with a vast variation of symptoms and mimic other pathologies. A 29-year-old male presented to A&E following a collapse. He had been suffering of diarrhoea and vomiting with lower abdominal discomfort. The patient was otherwise fit and well and no surgical history. On physical examination his abdomen was generally tender with no peritonism but was tachycardic, tachypneic but normotensive. His blood pressure dropped to 70/56, heart rate 130 and temperature increased to 41.2 degrees. A CT abdomen and pelvis with contrast was subsequently performed while on intensive care. There was a huge fluid-filled structure almost filling the entire pelvis and right side of the abdomen measuring up to 18cm in transverse diameter and 38cm longitudinally. The fluid filled structure appeared to communicate with a loop of small bowel in the right iliac fossa. There was no sign of obstruction. Due to the CT findings and the patient’s clinical status a laparotomy was performed. A large congenital duplication cyst was seen which was adherent to 40cm of the small bowel. The section of bowel was 130cm distal to the DJ flexure. The small bowel including the cyst was resected and hand sewn end-to-end anastomosis performed.