Gastric Duplication Cyst Research Articles

A rare case of multiple gastric duplication cysts in an adult

Intestinal duplications are rare developmental anomalies that can occur anywhere along the gastrointestinal tract. Gastric duplication cysts are uncommon congenital anomalies and are rarely diagnosed in adults. However, diagnosis of the condition in an adult can be difficult as it is usually asymptomatic, or the symptoms are nonspecific. Here we report a rare case of symptomatic gastric duplication cysts in an adult who was treated successfully with surgical resection.

An extremely rare culprit for a common crime: A case report on gastric duplication cyst associated with accessory pancreatic lobe

An extremely rare culprit for a common crime: A case report on gastric duplication cyst associated with accessory pancreatic lobe

A case of young male with recurrent acute pancreatitis caused by an intrapancreatic gastric duplication cyst

Gastric duplication cyst (GDC) is a rare gastrointestinal malformation that frequently occurs in the greater curvature of the gastric antrum or corpus. Herein, we reported a case of intrapancreatic GDC found as a result of recurring pancreatitis. A 15-year-old man experienced repeated episodes of acute pancreatitis and was found to have a cystic lesion in the pancreatic tail. Contrast-enhanced computed tomography revealed a 20-mm cystic lesion with an enhanced thick wall. Endoscopic ultrasonography revealed an anechoic cyst with a three-layered wall. Magnetic resonance cholangiopancreatography and endoscopic retrograde pancreatography (ERP) revealed a connection between the cyst and the main pancreatic duct (MPD), and the duplication of the MPD. ERP showed the pancreatic duct stenosis downstream of the cyst. Although preoperative diagnosis was difficult, distal pancreatectomy was performed to prevent recurrence of pancreatitis. Pathological examination revealed that the cystic lesion was circumferentially surrounded by the pancreatic parenchyma. The epithelial lining of the cyst was crypt epithelium containing the fundic or pyloric glands and surrounded by a smooth muscle layer. The final diagnosis was intrapancreatic GDC.

New treatment for gastric duplication cyst: Endoscopic ultrasonography-guided fine-needle aspiration combined with lauromacrogol sclerotherapy: A case report

BACKGROUND Gastric duplication cysts are very rare disease that are mainly diagnosed by endoscopic ultrasonographic fine-needle aspiration biopsy. In the past, this disease was usually treated with traditional surgery and rarely with minimally invasive endoscopic surgery. However, minimally invasive endoscopic therapy has many advantages, such as no skin wound, organ preservation, postoperative pain reduction, early food intake, fewer postoperative complications, and shorter post-procedure hospitalization. CASE SUMMARY We report a case of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) combined with lauromacrogol sclerotherapy for pyloric obstruction due to gastric duplication cysts. CONCLUSION EUS-FNA combined with lauromacrogol sclerotherapy provides a new option for the treatment of gastrointestinal duplication cysts.

Gastric duplication Cyst in a Child - An insight

Gastric duplication cyst is uncommon congenital anomaly in paediatric population with an incidence rate of 17 per million populations. Its diagnosis and treatment is challenging in infants and children for both the clinicians and the pathologists. Most of the cases, diagnosis is rendered on laparotomy followed by histopathology as could not be possible on clinical and imaging studies alone due to its varied presentation. The aim of this editorial is to highlight the morphology and rarity of gastric duplication cyst in children as less than 50 reported cases were available in literature.

A Multi-Centric Comparative Study Between Endoscopy-Assisted Laparoscopic Surgery (EALS) vs Laparoscopic Surgery for the Treatment of Gastric Duplication Cysts in Children.

To compare and analyze the therapeutic effects of endoscopy-assisted laparoscopic surgery (EALS) and laparoscopic surgery (LS) in the treatment of gastric duplication cysts (GDCs). We reviewed the clinical data of children with GDCs who underwent surgical treatment at Hubei Maternal and Child Health Hospital, Yijishan Hospital of Wannan Medical College, and Qingdao Women and Children's Medical Center from September 2014 to November 2022. The study comprised 29 children with GDCs, including 14 in the EALS group and 15 in the LS group. There was no significant difference between the two groups in terms of age, sex, weight, and cyst size characteristics. There was a significant difference between the two groups in terms of average surgical time (P>0.05), which was 1.100 ± 0.833 hours in the EALS group and 1.933 ± 0.159 hours in the LS group. There was a significant difference between the two groups (P<0.05) in average intraoperative blood loss, which was 7.93 ± 3.81 milliliters in the EALS group and 11.80 ± 2.72 milliliters in the LS group. There was a significant difference between the two groups (P<0.05) in average postoperative fasting time, which was 73.79 ± 8.36 hours in the EALS group and 114.1 ± 9.24 hours in the LS group. There was a significant difference between the two groups (P<0.05) in average postoperative hospital stay, which was 10.21 ± 4.25 days in the EALS group and 14.47 ± 4.36 days in the LS group. EALS technology can not only shorten surgical time, accurately locate GDCs, reduce injuries, and decrease the probability of complications but also achieve treatment goals safely and reliably.

Association of gastric duplication cyst with isolated oesophageal atresia and one additional floating rib — A rare presentation

A gastric duplication cyst is not a common anomaly of the alimentary tract. The most common site of alimentary tract duplication is the ileum. We found a non-communicating gastric duplication cyst, along with the greater curvature of the stomach during feeding gastrostomy for isolated Oesophageal atresia. We are reporting a gastric duplication cyst associated with isolated Oesophageal atresia and left side one additional floating rib. This is the third case report of gastric duplication cyst with Oesophageal atresia in English literature.

Heterotopic duplication cysts

Enteric duplication cysts are a rare finding, most commonly found in young children with many being seen on prenatal ultrasound. Gastric duplication cysts are a rare form of duplication cyst accounting for less than 10% of all duplication cysts, with the majority found in females. Rarely, these cysts can have clinically important ectopic tissues including gastric, duodenal, and pancreatic tissues, so can present with ectopic gastric ulcers and, very rarely, perforate or hemorrhage. We present a case report of two patients seen at Tufts Children's Hospital with a duplication cyst. The first patient presented with a heterotopic duplication cyst attached to the head of the pancreas with no communication with the alimentary tract and the second patient presented with a heterotopic duplication cyst attached to the tail of the pancreas, again with no communication with the alimentary tract, both consistent with gastric-type mucosa on pathological examination. We were unable to find any previously documented evidence of heterotopic duplication cysts that did not involve communication with the stomach, attachment via a common wall to the stomach, or a shared blood supply. Gastric duplication cysts are a rare form of duplication cyst in general, and rarely present with complications such as ulcers or cancer, but are favored for surgical management given the risks of mass effect or other symptoms as well as the rare risks for other complications including hemorrhage or erosion. Embryologically, the development of duplication cysts is thought to be related to the recanalization phase of the bowel lumen. Multiple management modalities have been described in the literature, with the most common being surgical resection if possible, or cystogastrostomy if unresectable. Both patients recovered well post-operatively and continue to be followed in clinic.

Gastric duplication cyst with peristalsis.

A 24-year-old male presented with an asymptomatic right perirenal cyst that was detected on ultrasound performed during a physical screening. Abdominal computed tomography showed a hypodense cystic mass between the liver and right kidney. Peristalsis of the cystic mass was observed via multi-phase CT scan, including plain scan, arterial phase, venous phase and delayed phase. The mass was completely resected by laparoscopy.

Gastric Duplication Cyst in 4 Years Male Child: A Rare Case Report

Gastric duplication cyst is an unusual congenital malformation of the gastrointestinal tract representing 4% of all alimentary tract duplications. Clinically the patients may remain asymptomatic or symptoms can be nonspecific, which include abdominal mass, pain, nausea and emesis. We report a four year old male child who presented with intermittent pain in abdomen. The child was evaluated for the same by radiology which suggested a duplication cyst in epigastric region. The child underwent excision for the same following which histopathology confirmed the diagnosis of gastric duplication cyst (Gastric mucosal cyst).

Gastric duplication cyst with ectopic pancreas in a teenager successfully resected by endoscopic submucosal dissection

BackgroundGastric duplication cyst associated with ectopic pancreas is rare and we aimed to alert clinician to this congenital anomaly.Case presentationA 15-year-old girl presented with intermittent vomiting. Gastroscopy showed a submucosal tumor with an approximate diameter of 40 mm in the anterior wall of the gastric antrum. The lesion had a central umbilication and was diagnosed preliminarily as gastric ectopic pancreas with pseudocyst formation on the basis of its appearance. However, computed tomographic scan showed a thick-walled cystic lesion with an enhanced outline of the cystic wall in the antrum of stomach, suggestive of duplication cyst. Serum amylase was normal. Endoscopic ultrasonography revealed a solid-cystic lesion; the solid portion were inhomogeneously mixed with echoes, and had indistinct border to muscularis propria; the cystic portion had echogenic internal mucosal layer and distinct border to muscularis propria. Endoscopic submucosal dissection (ESD) was suggested for the patient to relieve symptoms and diagnose the lesion definitely. The operation procedure was uneventful and the solid-cystic lesion was resected completely. Histopathologic examination revealed that the solid portion was ectopic pancreas, and the cystic portion was gastric duplication cyst. After resection, the patient discharged successfully and neither symptoms nor tumors recurred during the 9 months follow-up period.ConclusionsThis is the first case of a solid-cystic lesion with central umbilication in the stomach diagnosed as gastric duplication cyst associated with ectopic pancreas. ESD could be an optional treatment to provide a definitive diagnosis.

S2667 Upper Gastrointestinal Bleed From a Gastric Duplication Cyst

Introduction: A gastric duplication cyst (GDC) is an uncommon congenital malformation and a rare cause of upper gastrointestinal bleeding. Herein we present a peculiar case of an 83-year-old female with first ever onset of melena found to have a duodenal bulb fistula connecting to a bleeding extraluminal gastric pouch which was ultimately found to be a large GDC. Case Description/Methods: An 83-year-old female with history of bladder cancer treated with laser ablation, gastroesophageal reflux disease (GERD) on omeprazole, and a reported history of a “second stomach” presented to the emergency department with four days of painless, black, and sticky stools with one episode of non-bloody, nonbilious emesis prior to presentation. Presenting vitals were unremarkable, and pertinent laboratory workup demonstrated hemoglobin of 9.4 grams/deciliter, blood urea nitrogen of 35 milligrams/deciliter (mg/dL), and creatinine of 0.8 mg/dL. Esophagogastroduodenoscopy revealed the appearance of a bulge on the greater curvature of the stomach, and a duodenal bulb fistula was found connected to an actively bleeding extraluminal gastric pouch. The pouch could not be fully intubated endoscopically. Computed tomography angiography abdomen/pelvis displayed a possible gastric variant or duplication with a 2.9 centimeter enhancing mass in the proximal region without active extravasation of blood. She continued on intravenous pantoprazole and had one additional episode of melena but remained stable. She underwent partial gastrectomy, duodenal resection, Roux-en-Y gastrojejunostomy, and cholecystectomy without complications. Pathology showed a gastric duplication cyst lined with benign oxyntic mucosa. She was discharged. (Figure) Discussion: Gastrointestinal (GI) duplication cysts are found throughout the GI tract. They may or may not communicate with the GI lumen. Gastric mucosa is present in 50% of GI duplication cysts; they may remain asymptomatic but complications include ulceration, perforation, fistula formulation, and in rare cases gastrointestinal bleeding. Our patient went 83 years without GI bleed or other significant sequelae from the presence of a large GDC, highlighting the variable and unpredictable clinical course of this rare congenital abnormality.Figure 1.: FigureA: Endoscopic view of duodenal bulb fistula connecting to extraluminal gastric pouch lined with gastric mucosa. FigureB: Resected gastric extraluminal pouch post surgical intervention.

Gastric Duplication in a Preterm Neonate

Background: Gastrointestinal (GI) duplication is defined as a spherical structure with a muscular coat and is lined by a mucous membrane. It is a rare congenital anomaly. Clinical Description: A preterm baby born, delivered at 31 weeks, was diagnosed with respiratory distress syndrome and managed as per hospital protocol. While being weaned off from nasal continuous positive airway pressure, feeding was started. He developed vomiting and epigastric distension within 6 h. Management: The baby was investigated for the cause, and an early-onset sepsis was excluded. X-ray abdomen showed distended stomach and gas shadows in the bowel loops. Ultrasound did not reveal any gastric outlet obstruction, but significant gaseous distension of the stomach prompted us to make a dye study of the upper GI tract, which revealed cystic outpouching of the stomach that communicated with the gastric lumen. Similar findings were seen on computed tomographic scanning. Exploratory laparotomy performed revealed a large cyst communicating with the stomach at the lesser curvature. This was dissected out entirely from the margin of the stomach. Histopathology revealed highly congested cyst wall with an inner lining of gastric epithelium and gastric glands and an outer smooth muscle coat, confirming a gastric duplication cyst. Conclusion: Gastric duplication should be considered as a differential in newborns with feed intolerance, epigastric distension, and significant distension of the stomach. Although serial radiological investigations provide supportive evidence for this condition, the diagnostic confirmation is obtained by gross inspection and histopathology. In view of high risk of malignant transformation, surgical resection of the entire cyst remains the most definitive management.

Endoscopic submucosal dissection with ductotomy for the resection of a gastric duplication cyst with a communicating duct.

Video 1The endoscopic submucosal dissection of the gastric duplication cyst with ductotomy of an incidental communicating duct.

Pathological diagnosis, differential diagnosis and origin investigation of easily misdiagnosed adult gastric duplication cysts.

To study diagnosis, differential diagnosis, and origin of easily misdiagnosed adult gastric duplication cysts. Six cases with GDCs were studied using immunohistochemical methods to research the expression of tumor markers. Most GDCs were located in the abdominal cavity outside the digestive organs. The cyst wall tissues included a repetition of the full-thickness structure of the stomach wall that was lined by a variety of different epithelia. The expression of CK7 was positive in all epithelia (6/6), while CK7 expression was positive in cardia glands in 5/5 and positive in fundus glands in 1/5. CK 20 was 100% (4/4) positively expressed in the SCE, 100% (3/3) negative in the CCE, and in the SE. It was also expressed positively 100% (5/5) in fundus glands and 80% (4/5) in cardia glands. Both CK7 and CK20 were negatively expressed in the pyloric glands in case 3. The expression of MUC1 was positive in all epithelia and glands, whereas MUC2 expression was negative. MUC5AC was expressed differently in epithelia and glands. GDCs can originate from the antrum or the fundus of the stomach. Tumor markers can help diagnosis and differential diagnosis. This study may help to improve clinical precision treatment.

Endoscopic Septum Incision for Gastric Duplication Cyst: First Clinical Practice.

Endoscopic Septum Incision for Gastric Duplication Cyst: First Clinical Practice.

Computed tomography findings in a case of gastric duplication cyst

Computed tomography findings in a case of gastric duplication cyst

Gastric duplication cyst

Gastric duplication cyst

Gastric duplication cyst: rare cause of upper gastrointestinal bleeding in a young adult, with a review of literature

Duplication cyst along the alimentary canal is a congenital anomaly which is rare and usually incidentally found at endoscopy or radiological imaging. It can develop anywhere along the alimentary canal with only 4% occurrence in the stomach. Only few cases of gastric duplication cysts were reported to be symptomatic along with its complications. Diagnostic modalities include oesophageo-gastroduodenoscopy (OGDS), endoscopic ultrasound (EUS), computerized tomography (CT) scan and magnetic resonance imaging (MRI). However, the best option to confirm the diagnosis is complete resection of the lesion. We are reporting about a teenage girl whereby she presented with sudden episodes of hematemesis, which led to a syncopal attack. She also complained of intermittent central abdominal pain for a month prior to her presentation. Physical examination was unremarkable. However, her blood investigation showed a significant drop in hemoglobin. The patient had an endoscopy during which a submucosal lesion at the greater curvature was identified and the provisional diagnosis we had was a gastrointestinal stromal tumor (GIST). CT scan of the abdomen was also done showing an endoluminal cystic gastric lesion measuring approximately 2×2×2 cm. The lesion was confined to the stomach with no local infiltration of the adjacent structures. Decision was made to proceed with a laparoscopic wedge resection after outweighing the risk and benefits of surgery. Gastric duplication cyst is a rare anomaly. Despite its rarity, it should be included as a differential when we encounter a submucosal lesion due to its tendency for malignant transformation and other complications.

Gastric antral duplication cyst: A case report

Alimentary tract duplications may be symptomatic or may be discovered incidentally. They are named for the organ with which they are associated.1 Congenital gastrointestinal (GI) tract duplication cysts are commonly located in the ileum (53%), mediastinum (18%), colon (13%), stomach (7%), duodenum (6%), rectum (4%), or oesophagus (2%)2. A single theory is insufficient to explain all types of duplications.3 Children may present with symptoms like vomiting, abdominal pain, lumps, or weight loss.4 The presence of ectopic gastric mucosa and the potential for malignancy remain matters of concern.2 Surgical management is essential for these rare cysts.5 We encountered a Bangladeshi boy with a gastric duplication cyst (GDC) that was pre-operatively diagnosed as a pancreatic cyst. A variety of imaging modalities failed to indicate GDC before the operation. Here we present the clinical course of the case and discuss the difficulties and problems in diagnosing GDC.