Duplication cyst of the stomach: features of diagnosis and treatment

Abstract

Introduction . Duplication cysts (DC) of the gastrointestinal tract are a rare congenital anomaly. According to its structure, DC is a homogeneous neoplasm, often spherical in shape, in the form of a doubling (duplication) of the wall of a hollow organ. The main methods for diagnosis of DC are upper gastrointestinal endoscopy (EGD), CT, MRI, and endosonography. The indications for surgical treatment of patients with DC are: rapid growth of neoplasms, localization in anatomically narrow places and functional sphincters, the presence of clinical symptoms in patients. This article presents a rare clinical case of a patient with a large duplication cyst of the gastric antrum close to pyloric zone with abscess formation in the cyst and obstruction of the gastric outlet. Materials and methods : a 27-year-old man complained of nausea, a feeling of heaviness and discomfort in the epigastrium, and periodically vomiting food eaten. Examination revealed a large duplication cyst 5x6 cm in size with signs of gastric outlet obstruction and gastrostasis. Patient underwent partial resection of the stomach with a cyst using hybrid laparo-endoscopic approach. Results : No intraoperative complications were observed. Postoperative period was uneventful. The patient was discharged on the 5th postoperative day. Endoscopic and X-ray control studies demonstrated a good motor-evacuation function of the stomach and pyloric patency. The duration of follow-up period is 18 months. Patient have no complaints. Conclusion : The treatment strategy for duplication cysts directly depends on the correct examination using modern diagnostic methods, which allow to detect the possible complications. Optimization of minimally invasive technology through the introduction of a hybrid approach demonstrates the benefits of the combined use of laparoscopic and endoscopic techniques, decreasing the disadvantages of each method separately and ensuring the organ-sparing nature of the intervention.