A rare case of acute abdomen in the adult: The intestinal duplication cyst. case report and review of the literature.

Andrea Aurelio Ricciardolo,Nicola Sforza,Alessandro Tarantini,Francesco Serra,Francesca Cabry,Tommaso Iaquinta,Roberta Gelmini,Donatella Mosca

doi:10.1016/j.amsu.2019.03.002

Abstract

IntroductionDuplications 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 caseHerein 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.DiscussionThe 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.ConclusionIt is important to include intestinal duplication in the differential diagnosis of acute abdomen, to ensure the best therapeutic strategy.

Highlights

Duplications of the gastrointestinal tract are rare congenital anomalies that can occur anywhere throughout the gastrointestinal tract
They share a common wall with an adjacent portion of the gastrointestinal tract but may or may not have a communication with the bowel lumen
A computed tomography (CT) scan confirmed the presence of a 44 × 43 × 70 mm structure with oval morphology, fluid content, The work was written in line with the SCARE criteria [1] below the title and the disclosure statement. ∗ Corresponding author

Summary

Introduction

Duplications of the gastrointestinal tract are rare congenital anomalies that can occur anywhere throughout the gastrointestinal tract, from the mouth to the anus. The duplications are located on the mesenteric border of the associated native bowel and vary in size and shape: cystic in 80% of cases and tubular in the remaining 20%, with or without other congenital anomalies. They share a common wall with an adjacent portion of the gastrointestinal tract but may or may not have a communication with the bowel lumen. More than 80% of the cases present before the age of 2 years as an acute abdomen or bowel obstruction, but many duplications remain ‘silent’ unless complications occur, and may not be diagnosed until adulthood. We report a case of colonic duplication in a 35 years old patient

Presentation of the case

Discussion

Findings

Conclusions

Conflicts of interest