Duplication Cyst Research Articles

Upper pouch oesophageal duplication cyst- A rare association with Tracheoesophageal fistula: A case report

Background: Oesophageal atresia (OA) has associated anomalies in 50 to 70 % of cases. The usual associations include cardiac, gastrointestinal, anorectal, renal, vertebral, or skeletal anomalies. Oesophageal duplication cyst as an association in OA is extremely rare. Despite the related embryogenesis of these two anomalies, there are very few cases reported. Case Presentation: We present a low-birth-weight neonate with Type C Tracheo-oesophageal fistula (TEF) with an associated oesophageal duplication cyst. Conclusion: Upper pouch oesophageal duplication with TEF is very rare and this is the fourth case managed concomitantly at primary surgery in English literature available.

Unroofing and argon mucosal remnant ablation of neonatal duodenal duplication cyst

BackgroundDuodenal duplication cyst is an uncommon foregut malformation usually diagnosed at birth or during infancy. Differently from elsewhere, sited small bowel duplications cannot be removed with simple bowel resection, because of the proximity of the biliary and pancreatic ducts also possibly with abnormal course.Case presentationWe report a duodenal duplication cyst in a newborn female requiring early surgery because of nutritional difficulties. The cyst was located adjoined to the second portion of the duodenum sharing part of its muscle wall with the bowel. It was treated by removal of all the esophytic cyst while the remaining mucosa on the common wall with the duodenum was ablated with argon plasma coagulation, preserving the bowel integrity. Early postoperative period was uneventful, and the child could be fed per os on the second day. Yearly follow-up was maintained until 16 years for the risk of recurrence and cancer change due to the incomplete excision. Clinic and echographic controls had always been stayed free from any sequelae.ConclusionsForegut duplications should be removed totally to prevent complications and the long-term risk of cancer, but a duodenal resection can be a harmful surgery in neonatal age. Duplication cysts that are impossible to remove totally can be treated by unroofing and argon plasma coagulation of mucosal surface remnants, avoiding the risks of major procedures also in newborns.

Fetal abdominal tumors and cysts.

This article reviews the contemporary diagnosis and management of the most common abdominal neoplasms and cystic lesions diagnosed in the fetus. Fetal tumors discussed include teratomas (sacrococcygeal, cervical or mediastinal), mesoblastic nephroma, nephroblastoma (Wilms’ tumor), neuroblastoma, and hepatoblastoma. Fetal abdominal cystic lesions discussed include ovarian cyst, choledochal cyst, intestinal duplication cyst, mesenteric cyst, simple hepatic cyst, and meconium pseudocyst. We discuss the rare indications for fetal intervention or fetal surgery and other perinatal management, including prenatal interventions and fetal surgery for sacrococcygeal teratoma. The lesions reviewed are detected by widespread use of screening ultrasonography during pregnancy. Work-up for these abnormalities may include fetal MRI which enhances the diagnostic accuracy of abdominal tumors and cystic lesions and can aid in characterization of the lesion in relationship to surrounding anatomic structures. Accurate prenatal diagnosis of such lesions permits recommendations for optimal location and timing of delivery, and inclusion of appropriate caregivers and expertise to facilitate postnatal management. Perinatal management of the fetus with a neoplasm requires consideration of the optimal timing and mode of delivery, and pediatric oncology and surgical specialty care. The majority of tumors diagnosed antenatally have good prognosis with current multimodality treatment.

Endoscopic resection of a complex gastric duplication cyst using a submucosal tunneling technique.

Endoscopic resection of a complex gastric duplication cyst using a submucosal tunneling technique.

A retroperitoneal supra-adrenal non-communicating gastric duplication cyst: a case report and comprehensive literature review

BackgroundGastric duplication cyst is a rare congenital anomaly. It is usually located in close proximity to the stomach. Nevertheless, there have been seldom reports in the literature that describe unusual locations. Retroperitoneal gastric duplications cysts are extremely rare and are usually confused with renal or adrenal cysts.Case presentationIn this case report, we are presenting a 2-year-old girl with a complaint of bouts of abdominal pain, found to have a retroperitoneal supra-adrenal cyst on imaging. She underwent laparoscopic resection of the cyst with uneventful post-operative course. The histopathological diagnosis was surprisingly gastric duplication cyst.ConclusionIn our review of the literature, the variability of this condition and its clinical manifestation are apparent. We also conclude that this diagnostic entity should be part of the differential diagnosis of intraperitoneal or retroperitoneal cysts and that laparoscopic resection of retroperitoneal cysts is the preferred approach.

WHAT DO WE KNOW ABOUT ALIMENTARY TRACT DUPLICATIONS IN CATS?

O presente trabalho trata-se de uma revisão de escopo de duplicações de trato gastrointestinal em gatos. Os critérios de inclusão foram determinados pela revisão de relatos de caso de duplicações gastrointestinais confirmadas por exame histopatológico, incluindo-se também neste trabalho um caso de um felino diagnosticado com duplicação cística duodenal em nossa instituição. Treze casos de duplicações gastrointestinais foram analisados, sendo que um animal possuía uma duplicação bifocal, totalizando, portanto, quatorze duplicações. As variáveis consideradas foram idade, sexo, raça, sintomatologia, localização anatômica, morfologia, presença de comunicação luminal, progressão para malignidade e recorrência. Aproximadamente 62% (n=8/13) dos gatos afetados apresentavam entre 4 meses a 2 anos de idade. Não foi observada predisposição quanto ao sexo, enquanto raça e sintomatologia variaram. Duplicações duodenais corresponderam a 36% (n=5/14). Duplicações císticas sem comunicação luminal 93% (n=13/14). Uma duplicação evoluiu para neoplasia e a recorrência de duplicações gastrointestinais entre os gatos foi de 15% (n=2/13). Evolução para obstrução, hemorragias e malignidade já foram descritas em humanos e gatos como consequência de duplicações gastrointestinais. Considerando a importância e o desafio diagnóstico desta afecção, conclui-se que o clínico veterinário de pequenos animais deve considerar as duplicações de aparelho digestivo no diagnóstico diferencial de gatos jovens com vômitos crônicos e massas císticas intestinais.

Prenatal Imaging Diagnosis of Suprarenal Lesions

Introduction: Prenatal suprarenal lesions represent diverse pathologies. This study investigated prenatal imaging features and regression patterns associated with specific lesion diagnoses. Methods: This is a multicenter retrospective review of fetuses with prenatally diagnosed suprarenal lesions between 2001 and 2019. Prenatal ultrasound and MRI characteristics, postnatal imaging, and clinical course were reviewed. Prenatal imaging findings were compared by the most common diagnoses and regression patterns. Results: Forty-four fetuses were prenatally diagnosed with suprarenal lesions. Diagnoses included pulmonary sequestration (n = 12; 27.3%), adrenal hemorrhage (n = 12; 27.3%), upper quadrant cyst (including 2 duplication cysts, 1 splenic cyst, and 3 indeterminate cysts), neuroblastoma (n = 4), adrenal hyperplasia (n = 3), bilateral adrenal calcifications (n = 1), and indeterminate lesions (n = 6). Sequestrations were uniformly left-sided (100 vs. 50%; p = 0.014) and diagnosed earlier in gestation than adrenal hemorrhages (p = 0.025). Sequestrations were also significantly more likely to have a prenatal feeding vessel (p = 0.005), low T1 MRI signal (p = 0.015), and no MRI blood products (p = 0.018) compared to adrenal hemorrhages. When comparing all 44 patients, a prenatal feeding vessel and low T1 signal on prenatal MRI were significantly associated with lesion persistence (p = 0.003; p = 0.044). Discussion/Conclusion: Imaging findings on prenatal ultrasound and MRI aid in the diagnosis of suprarenal lesions, including differentiating pulmonary sequestrations and adrenal hemorrhages.

Epidermoid cyst of the cecum resected by single-incision laparoscopic colectomy: a case report

BackgroundEpidermoid cyst arising from the cecum is extremely rare. Single-incision laparoscopic surgery is the latest innovation in minimally invasive surgery, and shortens incisions, improves cosmesis, and reduces postoperative pain. We report here the first description of a patient with epidermoid cyst of the cecum treated by ileocecal resection by single-incision laparoscopic surgery.Case presentationA 20-year-old woman presented to our hospital with abdominal pain in the right lower quadrant. Abdominal contrast-enhanced computed tomography showed a 56 × 35-mm cystic mass in the ileocecal area. Magnetic resonance imaging revealed a 56 × 43-mm, T1-hypointense, T2-hyperintense mass attached to the cecum. Gastrointestinal tumor or duplication cyst was suspected, and ileocecal resection was performed using single-incision laparoscopic surgery. Intraoperative examination showed the tumor as a round, whitish mass arising from the cecum. Operation time was 162 min, and intraoperative blood loss was 10 ml. Macroscopic examination showed a 56 × 45-mm elastic-hard, whitish, round mass arising from the cecal wall. Microscopic examination revealed the cyst wall lined by keratinized stratified squamous epithelium. No malignant findings were identified. The final diagnosis was epidermoid cyst of the cecum. The postoperative course was uneventful and she was discharged on postoperative day 5.ConclusionsA rare case of cecal epidermoid cyst is reported. Single-incision laparoscopic colectomy using an organ retractor represents a promising option for treating cecal epidermoid cyst.

Endoscopic fenestration with EUS guidance for esophageal duplication cyst.

Video 1Endoscopic fenestration of a large esophageal duplication cyst with an electrocautery knife, combined with interventional endosonography techniques to ensure safety.

Concurrent bronchopulmonary foregut malformations: a rare case of right-sided extralobar pulmonary sequestration and bronchogenic cyst

BackgroundBronchopulmonary foregut malformations are rare congenital malformations. It is extremely rare to have malformations that occur simultaneously. There is literature to show that extralobar sequestration is associated with other congenital anomalies, most commonly diaphragmatic hernias, and also with other bronchopulmonary foregut malformations (e.g., extralobar sequestration and congenital pulmonary airway malformations). However, very few case reports were found that reported extralobar sequestration and foregut duplication cysts and only one report of a right-sided complex foregut malformation with pulmonary sequestration.Case presentationWe present a case of a 3-month-old male infant with a prenatal diagnosis of a cystic lung lesion who, after developing symptoms of respiratory distress, was found to have concurrent right-sided extralobar pulmonary sequestration and a mediastinal bronchogenic cyst.ConclusionsThe concurrent occurrence of these malformations in one patient could help support the theory that these malformations result from an early error in development during the time when both the lung buds and foregut are developing simultaneously.

Unilateral vocal cord paresis following excision of a large esophageal duplication cyst via median sternotomy in a neonate

Abstract A newborn, prenatally diagnosed with a cystic mass, possible esophageal duplication cyst, of the upper posterior mediastinum was admitted to our department with symptoms of worsening respiratory distress. A median sternotomy and complete cyst resection were performed, yet worsening respiratory distress was a major concern in the immediate postoperative period which led to further hospitalization and investigations. Surgical resection is the gold standard in therapy for esophageal duplication cysts as reported by all authors that have published such cases. Resection is considered the safest approach to prevent a patient from complications such as hemorrhage, infection, perforation and malignant transformation, yet very few data are published regarding operative complications and pitfalls.

English

BACKGROUND Abdominal cystic lesions are not so uncommon in the paediatric age group. Ultrasonography (USG) is the initial investigation of choice for detection of lesions. Computed tomography (CT) and magnetic resonance imaging (MRI) further compliment the findings of USG and help in the final diagnosis of various abdominal lesions in this age group. Because of the overlap in imaging features, histologic analysis is usually necessary to establish a diagnosis. The major role of the radiologist is to document the cystic nature of these abdominal masses and to determine the origin. Our aim was to study the incidence of cystic abdominal lesions in the paediatric age group and role of imaging in the diagnosis of various types of cystic lesions. METHODS This is a cross sectional study of 60 children who have been referred to radiology department with abdominal symptoms, over a period of 18 months (from April 2018 to September 2019) in Niloufer hospital, Hyderabad. Children suspected to have abdominal lesions have been referred to radiology department. USG is the initial investigation done and further CT / MRI has been done according to the findings on USG. Paediatric patients of age day 1 to 12 years, both male and female suspected to have abdominal cystic lesions either clinically or sonologically have been included in the study. Retroperitoneal lesions are excluded from study. RESULTS Out of the 60 patients studied, 44 patients were females and the rest were males. The most affected age group was between 0 - 1 year which constituted to 50 percent of the total cases studied. The most common pathologies are ovarian cyst and duplication cyst which constituted about 49 % of the cases. Statistical significance has been observed between the gender and incidence of cystic lesions. CONCLUSIONS Imaging plays a key role in the evaluation of various types of cystic lesions in the paediatric age group and arrive at a particular diagnosis based on specific imaging features. The radiologist must consider patient age, clinical parameters and imaging findings to formulate the likely diagnosis of cystic lesions. USG being cost effective, widely available and with no risk of radiation has been chosen as the first modality for investigation. KEYWORDS Cystic Lesions, USG, CT / MRI, Ovarian Cyst, Enteric Duplication Cyst

Rectal duplication cyst mimicking rectal prolapse: A case report

Background: Gastrointestinal tract duplications are rare congenital malformations that are benign, presenting usually in childhood. Most common sites include the distal ileum and esophagus. Rectal presentation is quite uncommon and is usually cystic. Case Presentation: This is a case of a 3-year-old boy who came with rectal prolapse. On further examination and imaging investigations, a presacral cyst was located and a diagnosis of rectal duplication was made. The cyst was completely excised by a posterior sagittal approach. Conclusion: Rectal duplication is a rare entity that may simulate a rectal prolapse.

A case report of oral heterotopic gastrointestinal cysts (HGIC) and review of the literature

AbstractIntroductionHeterotopic gastrointestinal mucosa (HGM) found within the oral cavity has been reported as a rare type of anomaly. It can result in the formation of oral heterotopic gastrointestinal cysts (HGIC) which are thought to be either duplication cysts (surrounded by a muscular wall) or choristomas/heterotopic cysts (no muscular wall). The exact aetiology is poorly understood; they are thought to arise from misplacement or sequestration of the endoderm from the primitive stomach into the anlage of the tongue/developing oral cavity.MethodsWe present a rare case of a healthy 37‐year‐old Eastern European gentleman who was diagnosed with HGM of the anterior tongue. A systematic literature review method of PubMed, Embase and Medline was conducted.ResultsA systematic review of PubMed, Embase and Medline was conducted, revealing 68 reported cases in the English language. The age range was from newborn to 70 years old, 42/68 cases were reported in infants (1 year or less). Male:Female 1.3:1. Of these patients six reported previous surgery and three reported previous failed aspirations/incision and drainage. In infancy/childhood it usually presents with problems with feeding/swallowing.Clinical RelevanceMRI T2 weighted imaging produces a high signal due to a well‐defined cyst like appearance with imaging appearances being the same in infants as to those in adult patients. The majority of these cases cause feeding and breathing issues in the infant. However, this lesion had remained asymptomatic for over 30 years before causing discomfort with swallowing. This case reveals that these lesions can remain asymptomatic before causing problems in later life and the clinician should be aware of having it as part of a differential diagnosis.

Ileocolic Intussusception in an Infant with Ileal Duplication Cyst as a Lead Point- A Case Report

Gastrointestinal duplication cysts are uncommon congenital malformations, with small intestine being the most common site, followed by colon and stomach. It can have variable presentations such as intestinal obstruction, bleeding, palpable mass, or rarely volvulus. Here, the authors report a case of intussusception in a two-year-old child, presented with complaints of bilious vomiting and abdominal distension for three days with X-ray features suggestive of bowel obstruction. Ultrasonography revealed intussusception with ileal duplication cyst as the lead point, which was confirmed on exploratory laparotomy. In a paediatric patient, enteric duplication cyst should be included in the differential diagnosis of a cystic lesion as the lead point in intussusception.

Update on transumbilical laparoscopic-assisted surgery in infants and neonates.

Background:Because of the restricted space of the peritoneal cavity and the easy mobility of abdominal and pelvic organs in infants and neonates, the boundary of minimally invasive surgery was extended to complete the operation outside the abdomen. The objective of this study was to report our experience with transumbilical laparoscopic-assisted surgery (TULS) in different abdominal pathologies in infants and neonates.Patients and Methods:A retrospective study was conducted on 59 patients who underwent TULS from 2014 to 2020. The study outcomes were the conversion to open approach, length of hospital stay and post-operative complications.Results:The most common indications were explorations for intra-abdominal testes (n = 15) and inguinal herniorrhaphy (n = 13). Patients who had surgery for pyloric stenosis were younger (1.03 ± 0.25 months). The average operative time was 45.9 ± 18.39 min. The longest operative time was reported with surgery for liver cysts (94.5 ± 10.6 min). Oral intake was started after 48–56 h in patients who had excision of duplication cysts. The average post-operative hospital stay was 2.6 ± 1.52 days. No major complications were reported. Wound infection occurred in one patient with a duplication cyst. Three patients were converted to open repair (5.1%) and no late complications were reported during the mean follow-up time of 11.2 ± 5.1 months.Conclusions:The transumbilical approach is a safe alternative method to laparotomy in several abdominal pathologies in infants and neonates. It has a short operative time and hospital stay. The technique is associated with few complications and conversion rates.

Gastrik Duplikasyon Kisti: Ender Bir Olgu Sunum

Duplication cysts are developmental anomalies of gastrointestinal tract that can occur at any level from the oral cavity to the rectum, and are extremely rare in the stomach. Most patients show symptom and findings in the first year of life. The most common symptom and findings are abdominal pain, nausea, vomiting, anemia, weight loss and palpable mass. In this study, a gastric duplication cyst was presented in an 11-month-old patient.

Ileocecal-Valve-Preserving Operation for the Cystic Intestinal Duplications of the Terminal Ileum: Report of Two Cases

Ileocecal-Valve-Preserving Operation for the Cystic Intestinal Duplications of the Terminal Ileum: Report of Two Cases

An uncommon location of a Meckel's diverticulum mimicking small intestinal duplication cyst

An uncommon location of a Meckel's diverticulum mimicking small intestinal duplication cyst

Minimally invasive surgery for adult oesophageal duplication cysts: Clinical profile and outcomes of treatment from a tertiary care centre and a review of literature.

Background:Oesophageal duplication cysts (ODC) are rare in adults. Complete surgical excision is the ideal treatment. Conventionally, it is performed through a thoracotomy. We aimed to study the feasibility and safety of minimally invasive surgery (MIS) in the management of ODC and briefly reviewed the available literature.Materials and Methods:A retrospective study of all adult patients with ODC diagnosed and treated at our tertiary care centre, from 2015 to 2019, was done. All patients were operated on by MIS. Their demographic, clinicopathological, radiological and surgical details and outcomes were analysed.Results:A total of six patients (four females and two males) were diagnosed to have ODC by contrast-enhanced computed tomography. The mean age was 38 ± 4.4 years. The most common presenting complaint was chest pain (50%). Upper gastrointestinal endoscopy was normal in four patients. Endoscopic ultrasound was performed in five patients. In four patients, the cyst was located in the distal third of the oesophagus. The mean size of the cysts was 5.7 ± 2.02 cm. All the patients were operated upon by video-assisted thoracoscopic surgery (VATS). There was no conversion to open surgery. The resection was complete in all but one patient. The mean duration of surgery was 143.3 ± 35 min, and the average blood loss was 58.33 ± 20.4 mL. One patient had an oesophageal staple line leak on the 9th post-operative day. There was no mortality. The median duration of hospital stay was 7.5 days (range: 3–25 days).Conclusion:MIS is feasible and safe in the management of adult ODC.