Abstract
This report describes a two-month-old girl who presented with signs and symptoms of a distal small bowel obstruction. She underwent an abdominal ultrasound that revealed a right lower quadrant cystic mass. A Technetium-99 scan revealed increased activity in the right lower quadrant consistent with a Meckel's diverticulum. Following a nondiagnostic laparoscopic evaluation, a laparotomy was performed to allow direct palpation of the small bowel and colon. Direct palpation of the ileum revealed a soft intraluminal mass at the ileocecal valve. The child underwent an ileocecectomy and anastomosis incorporating the intraluminal mass. Pathologic analysis revealed an intraluminal enteric duplication cyst containing ectopic gastric mucosa. This case represents the first report of such an entity in an infant. A discussion of the diagnostic and therapeutic aspects of the case and enteric duplication cysts is provided.
Highlights
Enteric duplication cysts are rare malformations with a reported incidence of 1 in 4500 with 80% of these diagnosed before the age of two [1]
We present a case of a duplication cyst containing gastric mucosa that was entirely intraluminal and undetectable by laparoscopic evaluation
Enteric duplication cysts can occur anywhere from oropharynx to rectum and have three major characteristics: (1) the presence of a smooth muscle coat, (2) an epithelial lining representing a type of intestinal mucosa, and (3) an anatomic association with a portion of the gastrointestinal tract [1]
Summary
Enteric duplication cysts are rare malformations with a reported incidence of 1 in 4500 with 80% of these diagnosed before the age of two [1]. Management of enteric duplication cysts involves surgical resection often performed laparoscopically [1]. We present a case of a duplication cyst containing gastric mucosa that was entirely intraluminal and undetectable by laparoscopic evaluation. A laparotomy was necessary to locate the duplication cyst by manual palpation. There are no previous reports of a completely intraluminal ileal duplication cyst containing gastric mucosa
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