Neonatal Duplication Cysts of Esophagus Present with Respiratory Distress: A Case Report

Abstract

A full-term male neonate presented with low body weight, respiratory distress and poor activity after delivery via cesarean section. After medical treatments, respiratory distress improved gradually. However, pulmonary alveolar consolidation over right upper lobe on chest X-ray persisted. Following chest X-ray revealed air-contented structure over mediastinum and right pericardial regions. Esophageal duplications were further confirmed by MDCT (multi-detector computed tomography) - reconstructed 3-D images. Esophageal duplication cysts are uncommon congenital anomalies which often result from abnormal embryological developments. The cysts are generally found in posterior mediastinal region. The spherical cystic form is the most common presentation of the esophageal duplications, followed by tubular form. Compression on organs results in respiratory or gastrointestinal symptoms. Our case presented with combined cystic and tubular forms of esophageal duplications over anterior mediastinal region. Although early surgical intervention has been recommended in some literatures according to the risks of malignant changes and other complications as infection, ulceration, bleeding or perforation; some literatures suggest surgical treatment should be delayed until the presence of symptoms. Our case did not receive surgical intervention. After 2-year follow-up, the infant was in good health with normal growth and development. We emphasized that esophageal duplication cysts should be taken into consideration as uncommon causes in a neonate with respiratory distress.