Enteric Duplication Research Articles

Type 1a Duodenojejunal Tubular Duplication Cyst with Complex Rotational Anomaly Masquerading as Chronic Anemia

ABSTRACT Enteric duplication cysts and reversed intestinal rotation (RIR) are rare congenital anomalies, with their coexistence being exceptionally uncommon. We report a 4-year-old girl who presented with chronic anemia and intermittent abdominal symptoms since infancy. Detailed workup for medical causes of anemia was inconclusive. Computed tomography of the abdomen revealed intestinal malrotation with a grossly dilated small bowel loop. Intraoperative findings revealed a long duodenojejunal tubular duplication with a separate mesentery (Type 1a) and RIR. The patient underwent a Ladd’s procedure, resection of the duplication cyst, and end-to-end anastomosis. This case underscores the anatomical rarity, varied clinical presentation, and challenges in making an accurate and timely diagnosis in such a case.

An Isolated Enteric Duplication Cyst With Mucinous Neoplasm Presenting as a Mesenteric Cyst: A Case Report

An Isolated Enteric Duplication Cyst With Mucinous Neoplasm Presenting as a Mesenteric Cyst: A Case Report

Variations in Epithelial Lining of Duplication Cysts Cannot be Explained by Known Theories.

Objectives. Duplication cysts are found in any part of the gastrointestinal tract from the oropharynx to anus. Although duplication cysts usually have similar epithelium with the adjacent organ, respiratory epithelium in the enteric duplication cysts is rarely reported. This study was performed to evaluate the variations in the epithelial lining of duplication cysts and its clinical implications. Methods. Patients diagnosed with duplication cysts between 2012 and 2022 were retrospectively reviewed to assess their histopathological results, clinical aspects, treatment options, and demographic characteristics. Results. Twenty-five patients were included. The mean age was 4 years, male-to-female ratio was 15:10. The localizations of duplication cysts were ileum (n = 12), duodenum(n = 4), stomach(n = 3), jejunum(n = 2), colon(n = 2), thoracoabdominal(n = 2), and rectum(n = 1). Most common presentation was abdominal pain (36%). Intestinal (48%) and gastric (40%) epithelia were the most common finding. Four patients (16%) had respiratory epithelium: two in foregut duplication cysts, one each in ileal, and rectal duplications. Twenty-four percentage of patients had associated anomalies. Surgical interventions were performed on 22 patients. Conclusion. Duplication cysts show a wide range of epithelial linings. Respiratory epithelium can be found in not only foregut duplication cysts but also midgut and hindgut duplication cysts. Although the presence of respiratory epithelium did not have any impact on clinical findings, none of the previous theories explain the presence of respiratory epithelium different from foregut duplications.

Coexistence of Cecal duplication cyst and Meckel’s diverticulum presenting as intestinal obstruction: A rare case report

Introduction and importance: Enteric duplication cyst (EDC) is a rare congenital anomaly with incidence of 1 in 4500 live birth. Meckel’s Diverticulum (MD) is the most common congenital anomaly of gastrointestinal (GI) tract. The coexistence of EDC and MD in same patient is extremely rare. Presentation of EDC depends on it’s location, may present with dysphagia, respiratory distress, abdominal pain, abdominal distension and intestinal obstruction. However, MD remains asymptomatic in most of the cases. Case presentation: We present a case of 11month boy, presenting with fever, vomiting, and abdominal distension for four days and decreased frequency of defecation with fowl smelling stool, not mixed with blood. All the systemic examination findings were regular except soft and generalized distension of abdomen. CECT scan of abdomen showed features suggestive of EDC versus mesenteric cyst. The patient underwent exploratory laparotomy with ileocecal resection, ileocolic anastomosis and appendectomy. Meckel’s diverticulum was discovered incidentally at distal ileum, and was left intact. The patient was discharged in stable state. Clinical discussion: EDCs can occur anywhere in the GI tract, most frequently in small intestine and least often in cecum. MD is true diverticulum of small intestine. This case report discusses a rare occurrence of a pediatric patient having both an EDC and MD, emphasizing diagnostic and management challenges in such unique cases. Conclusion: Clinicians should be aware about simultaneous occurrence of EDC and MD in pediatric population who may present as intestinal obstruction.

Cecal duplication cyst in an adult: A case report

Enteric duplication cysts are rare congenital malformations and cecal duplication cysts are rarer which develop only in 0.4% of cases of gastrointestinal tract duplication and only 43 cases have been reported in literature to date. The ileum and ileocecal junction are among the most common sites. We hereby report a case of a 50-year-old female who presented with signs and symptoms of acute intestinal obstruction that was clinically and radiologically interpreted as volvulus for which the patient underwent resection of the cyst and ileocecal anastomosis and was then histopathologically confirmed as cecal duplication cyst.

Adult ileal duplication cyst acting as lead point of ileo-caecal intussusception a rare case of complete bowel obstruction in adults

Enteric duplication cyst presenting as intussusception in adult and causing complete small bowel obstruction is a rare phenomenon. A 19 year old female presented with complaints of abdominal pain, bilious vomiting, abdomen distension and constipation for 2 days. Patient had similar episodes in the past. Computed tomography of abdomen showed dilated small bowels with “Target Sign” suggestive of Ileo caecal intussusception. Patients was taken for surgery and intraoperatively it was noted to have thick walled cystic swelling in the terminall ileum. Segmental resection done along with cyst and primary anastamosis was done. Histopathological confirmation was done as Duplication cyst.

Enteric duplication cyst as a rare presentation of adult acute abdomen

Enteric duplication cyst as a rare presentation of adult acute abdomen

Enteric Duplication Cyst –A Rare Congenital Anomaly in Adolescence Presenting as Recurrent Pain Abdomen

Case Report: Presented by Dr. Harleen Bawa and Dr. Parthasarathi Hota, this case involves an 18-year-old male with recurrent abdominal pain, nausea, and fever. Initially suspected of congenital gastrointestinal malformation at 1 year, the patient underwent conservative management until symptoms reappeared. Imaging revealed blind-ended tubular structures attached to the small bowel, prompting further investigation for a definitive diagnosis. Management: An exploratory laparotomy revealed an enteric duplication cyst in the ileal region, 50 cm from the ileocecal junction. Resection of the involved ileum with end-to-end anastomosis was performed. Mesenteric lymphadenopathy and an inflamed appendix were also addressed. Biopsy results indicated changes consistent with chronic appendicitis. In Radiological findings CT images displayed well-defined blind-ended tubular structures arising from the distal ileum, suggesting Meckel’s diverticulum. Fluid density cystic lesions near the duodenum and pancreas raised the possibility of an enteric duplication cyst. Discussion: Enteric duplication cysts, though rare, can manifest with varied symptoms, including recurrent abdominal pain and intestinal obstruction. Imaging techniques such as CT, USG, and technetium pertechnetate scanning aid in diagnosis. Resection of the cyst and adjacent intestine with end-to-end anastomosis is a common surgical approach. The prognosis is excellent when complete excision is possible without compromising intestinal length. Conclusion: Enteric duplication cysts, located along the gastrointestinal tract, may present challenges in diagnosis and management. Surgical intervention, guided by imaging and clinical findings, often leads to favorable outcomes. Awareness of potential complications, such as bowel obstruction and bleeding, is crucial for timely intervention.

Multiple isolated enteric duplication cysts in newborn: An unusual cause of sepsis

Gastrointestinal duplication cysts are uncommon congenital anomaly that may occur anywhere throughout the gastrointestinal system from the mouth to the anus. While cysts occur usually in the small bowel, the stomach ranks third after the small intestine and esophagus. As these cysts may be complicated by infection and other complications such as bleeding or obstruction, they should be treated with complete excision before the symptoms start. Although duplication cysts more often cause symptoms related to signs of obstruction, they may also present with clinical sepsis. In this article, we present a newborn case with a large duplication cyst adjacent to the ileum and the greater curvature of the stomach and a second simple cyst under the liver.

Jejunal duplication cyst in a female neonate: a case report.

Duplications are the abnormal portion of the intestine, either externally attached to the intestine or intrinsically placed within the bowel lumen. Their prevalence is noted to be around one in 25000 deliveries. The rare gastrointestinal tract duplication may be located in any part of the gastrointestinal system from the oral cavity to the anus. The most common site of enteric duplication cyst (DC) is the terminal part of the ileum. Hence, duplications in jejunum are rare. Hereby, the authors report a case of jejunal DC in a female neonate which was managed successfully via surgery and adequate post-operative care without any complications. Duplications are more frequently single. They are usually located in the mesenteric border of the associated native bowel and may vary in shape and size. Most of them are cystic, followed by tubular and mixed type, with or without other congenital anomalies. More than 80% of the cases present before the age of 2 years as an acute abdomen or bowel obstruction, but many duplications remain silent unless complications occur, and therefore may not be diagnosed until adulthood. Complications of enteric DC include volvulus, bleeding, and, rarely, malignant degeneration. It is important for paediatric surgeons to include DC in the differential diagnosis if a neonate presents with features of intestinal obstruction.

EP10.19: Enteric duplication cyst: challenges in differential diagnosis in an obese primigravida

EP10.19: Enteric duplication cyst: challenges in differential diagnosis in an obese primigravida

The laparoscopic surgery results of isolated enteric duplication in the transverse mesocolon: A case report

Enteric duplication cysts found throughout the alimentary tract are rare congenital mass lesions, which usually share a common wall with the gastrointestinal tract. However, many cases of isolated enteric duplication (IED) cysts, reported in the literature, are without any attachment to the gastrointestinal tract. We report a case of an IED cyst located in the transverse mesocolon, which was successful treatment with laparoscopy, in Children’s Hospital #1, Ho Chi Minh City, Vietnam. A girl turned 3 years old presented with dull abdominal pain and vomiting. Abdominopelvic computed tomography revealed a lesion located around duodenojejunal flexure with a thick wall. Laparoscopy detected a mobile cystic mass found on the mesentery of the transverse colon, which was not connection or attachment to any part of the adjacent intestine. Histopathology of the cyst wall was compatible with an EDC. The IED cyst is an unusual phenomenon that confuse with other diagnosis in clinical. The definitive diagnosis of IED is based on histopathology. Laparoscopic resection of the cyst is the preferred treatment.

A rare case presentation of combined enteric duplication cyst both tubular and cystic

Enteric duplication cyst are rare congenital malformations of children and can develop anywhere along the gastrointestinal (GI) tract being ileum the most frequent location, they don’t communicate with GI lumen. They are usually detected prenatally or in first years of life. The size, location, type, mucosal pattern produces varied clinical presentation and different imaging findings. Ultrasonography (USG) is the most commonly used imaging method for diagnosis. A 4-year-old boy was admitted in our hospital for recurrent on and off abdominal pain, on getting USG he has diagnosed has having tubular enteric duplication cyst on both USG and computed tomography (CT) scan. Surgery performed and resection and anastomosis done. Macroscopic and histologic findings confirmed the diagnosis of enteric duplication cyst arising from ileum. Although intestinal duplications are considered to be benign lesions, they may result in significant morbidity and mortality if left untreated.

Pyloric Duplication Cyst in Newborn Male.

An enteric duplication cyst (EDC) is a rare congenital anomaly. Although EDCs can occur at any point throughout the gastrointestinal tract, they are most commonly reported in the ileum and only around 5-7% are of gastroduodenal origin. We report a case of a pyloric duplication cyst in a 3hour old male with prenatal ultrasound showing a cystic mass. The patient had an abdominal ultrasound after birth that showed a mass with probable trilaminar wall. The diagnosis of pyloric duplication cyst was made in surgery and confirmed with histopathologic examination following resection. The patient is doing well with appropriate weight gain at follow-up appointments.

Quiste de duplicación entérica como presentación poco frecuente de abdomen agudo en adulto

Quiste de duplicación entérica como presentación poco frecuente de abdomen agudo en adulto

Histopathological Study Of Various Neoplastic And Non-neoplastic Lesions Of Small Intestine At Tertiary Care Centre Of South Gujarat

Introduction: Small intestine, the longest part of digestive tract, makes up about 75% of the total length and can be affected by various developmental, inflammatory or neoplastic conditions. Non neoplastic lesions like abdominal tuberculosis are frequently seen in small intestine. Although small intestine is an uncommon site for tumour nearly twothirds of these tumours are malignant, with most of them being adenocarcinoma. To study the histopat Objective: hology of various neoplastic and non-neoplastic lesions of small intestine and to evaluate their frequency and pattern with respect to age, sex, anatomical sites and clinical findings. This observational cross-sectional Materials and Methods: study was conducted on a total of 101 small intestinal specimens including biopsies and surgically resected specimen received for histopathological examination over a period of two years in the Department of Pathology affiliated with tertiary care hospital. In addition to Haematoxylin and Eosin staining, Immunohistochemistry and special stains were also done in required cases. This study showed a male is to female ratio of 1.97:1. Peak incidence of Results: cases was seen in the 31-40 years age group. Out of total 101 pathological lesions 87 cases were non -neoplastic that included Infective lesions like tuberculous enteritis, Inflammatory lesions like Non-specific Enteritis, Necrotising Enteritis and Congenital lesions like Meckel's diverticulum, Enteric Duplication cyst and Celiac disease while only 14 cases were neoplastic that included benign neoplastic lesions like various types of polyps and malignant neoplastic lesions like adenocarcinoma, GIST, neuroendocrine tumour and B cell NHL. This study showed a characteristic Conclusion: distribution of cases in the three different parts of small intestine and highlighted the clinical importance of timely detection of intestinal pathology by the means of detailed clinical study combined with radiological and histopathological examination.

Enteric duplication cyst in an infant with recurrent vomiting

Enteric duplication cysts (EDCs) are relatively rare but important because they can arise anywhere from the mouth to the anus and cause gastrointestinal obstruction, bleeding, and volvulus. We describe a case of an EDC in a 4-month-old boy who presented with recurrent vomiting and abdominal distension. Ultrasonography revealed a large cystic lesion on the ileocecum. As specific signs of the EDC on ultrasonography, the “double-wall” sign and “Y” sonographic configuration were identified, and a cystic ileocecal duplication was diagnosed. The patient underwent surgical resection of the cyst and was discharged from the hospital without sequelae. EDCs can be used for the differential diagnosis of recurrent vomiting and abdominal distension. Pediatricians should carefully observe the wall and adjacent connection of cysts using ultrasonography, because the specific signs seen on ultrasonography scans can differentiate EDCs from other abdominal cysts or tumors.

Senhance Robotic Platform in Pediatrics: Early US Experience

Different robotic systems have been used widely in human surgery since 2000, but pediatric patients require some features that are lacking in the most frequently used robotic systems. The Senhance® robotic system is a safe and an effective device for use in infants and children that has some advantages over other robotic systems. All patients between 0 and 18 years of age whose surgery was amenable to laparoscopy were offered enrollment in this IRB-approved study. We assessed the feasibility, ease and safety of using this robotic platform in pediatric patients including: set-up time, operative time, conversions, complications and outcomes. Eight patients, ranging from 4 months to 17 years of age and weighing between 8 and 130 kg underwent a variety of procedures including: cholecystectomy (3), inguinal herniorrhaphy (3), orchidopexy for undescended testes (1) and exploration for a suspected enteric duplication cyst (1). All robotic procedures were successfully performed. The 4-month-old (mo), 8 kg patient underwent an uneventful robotic exploration in an attempt to locate a cyst that was hidden in the mesentery at the junction of the terminal ileum and cecum, but ultimately the patient required an anticipated laparotomy to palpate the cyst definitively and to excise it completely. There was no blood loss and no complications. Robotic manipulation with the reusable 3 mm instruments proved successful in all cases. Our initial experience with the Senhance® robotic platform suggests that this is a safe and effective device for pediatric surgery that is easy to use, and which warrants continued evaluation. Most importantly, there appears to be no lower age or weight restrictions to its use.

Jejunal duplication presenting with perforation peritonitis: Complication of a rare congenital malformation in an elderly female

Intestinal duplication is a rare congenital malformation that is usually detected or becomes symptomatic in early paediatric age and is rarely reported in adults. The ileum is the most frequent site, while jejunum is rarely involved. Features are often nonspecific, hence difficult to diagnose. Ultrasonography is often preferred imaging method. The surgical procedure is determined depending on the presentation. We present a case of an adult female presenting with perforation peritonitis. Intraoperatively, approximately 6 cm length communicating jejunal tubular duplication over the mesenteric margin was found, with perforation involving the duplication segment and normal jejunum. Resection of jejunal duplication segment and anastomosis was carried out. This presentation proposed further insight into enteric duplication and their clinical presentations, along with emphasis on how and why this entity was missed preoperatively and came out to be an intra-operative surprise.

A large abdominal cyst in a neonate

Gastrointestinal (enteric) duplication consists of a tubular or cystic structure that develops along the intestinal tube, with an estimated incidence of 1/10,000 in live births and 1/4500 in necropsies of neonates and fetuses. This congenital anomaly can appear in any portion of the intestinal tract; from the mouth to the rectum, with the ileum being the most common location. We herein report the case of a 5-day-old patient with a prenatal diagnosis of megacolon or mesenteric cyst. At laparotomy, a cystic mass attached to the terminal ileum was noted approximately 5 cm from the ileo-caecal valve. This mass was entirely resected and pathology studies classified the specimen as Type 1B intestinal duplication according to the Long classification. Intestinal duplications are rare abnormalities of the embryological development of the gastrointestinal tract and usually present in childhood. The diagnosis can be made during antenatal follow-up. They can be asymptomatic or present with a variety of symptoms in relation to the location, the age of the patient or complications of the duplication. The diagnosis is suggested by abdominal X-rays and ultrasonography, and computerized axial tomography scan with contrast studies, but the definitive diagnosis is made by histopathological examination of the surgical specimen.