Chronic gastroesophageal reflux disease secondary to a distal esophageal duplication cyst associated with a hiatal hernia

Abstract

Esophageal duplication cysts are asymptomatic gastrointestinal anomalies that are infrequently seen, usually diagnosed as a secondary finding. In adults, they can be associated with gastroesophageal reflux disease (GERD) and are usually detected with a radiologic study. We report the case of a 55-year-old woman with a 2-year history of pyrosis, regurgitation, coughing fits, and dysphagia. An esophagogastroduodenoscopy (EGD) was done, detecting a subepithelial lesion at the gastroesophageal junction with a type I hiatal hernia; endoscopic ultrasound and a CT scan were performed, showing a distal esophageal mass that generated a narrowing of the esophageal diameter with proximal dilation. An esophageal duplication cyst was diagnosed. Excision of the mass, hiatoplasty, and gastric fundoplication were auspiciously achieved by an abdominal transhiatal approach. A year after the procedure, the patient is asymptomatic and without complications. If a patient presents with epigastric pain and GERD-like symptoms, with no benefit from medical treatment, an esophageal duplication cyst must be a differential diagnosis. This can be confirmed with a CT scan and endoscopic ultrasound, with surgery being the best treatment for this disease