Gastric Duplication Research Articles

Endoscopic submucosal dissection for gastric duplication cyst with heterotopic pancreas

Endoscopic submucosal dissection for gastric duplication cyst with heterotopic pancreas

Acute inflammation of gastric duplication cyst in a toddler

Gastric duplication cysts (GDC) are rare types of gastrointestinal tract duplications, with various clinical presentations described in the literature. We herein report a 15 months old male toddler who presented to the emergency department with an acute abdomen and septic shock. After initial resuscitation, an upper gastrointestinal contrast study was done and showed a filling defect at the great gastric curvature. Surgical exploration revealed an inflamed gastric duplication cyst which was excised completely. This is a rare presentation of GDC. Accurate diagnosis of these cysts before resection is important. The clinical picture, diagnosis, and management options are described and compared to findings in the literature. In our best knowledge, this is the first case of gastric duplication which presents for the first time with inflammation in a toddler.

Duplicaciones del tracto gastrointestinal en niños, presentación de dos casos. Hospital Infantil Doctor Robert Reid Cabral (HIRRC), República Dominicana

Introducción: la duplicación gastrointestinal es una ano-malía relativamente rara que puede ocurrir en cualquier nivel desde la cavidad bucal hasta el recto, los casos de duplicación gástrica son aún más raros, y la mayoría de ellos se han reportado en niños.
 Material y método: en el siguiente trabajo se expone dos casos; número 1: paciente de sexo femenino de 2 años de edad, con presentación clínica de vómitos de contenido alimentario que luego se tornaron biliosos en número de 3-4 ocasiones por día, de 2 días de evolución, dolor abdo-minal difuso de 2 días de evolución, masa abdominal localizada en hemiabdomen derecho. Caso número 2: paciente masculino de 4 días de vida, a quien se realiza ultrasonido obstétrico a las 34 semanas de gestación, donde se evidencia imagen quística nivel abdominal. A ambos casos se le realiza laparotomía exploratoria eviden-ciando en caso número 1: duplicación gástrica al que se le realiza exéresis total y rafia gástrica, y el caso número 2: malrotación intestinal con vólvulo de intestino medio más duplicación intestinal (ileal), al que se le aplica proce-dimiento de Ladd más resección y anastomosis termino terminal ileoileal, ambos pacientes evolucionan de manera satisfactoria.
 Conclusión: el propósito consiste en describir la presen-tación de ambos casos en la infancia, lo importante de los métodos diagnósticos y de la corrección quirúrgica por diferentes técnicas según la localización del quiste en el tracto gastrointestinal.

Gastric duplication cyst in an infant: A case report

Abstract Gastrointestinal duplication is an infrequent congenital disorder, presenting a mucosal-covered muscle layer. Gastric duplication cysts comprise about 2–9% of all gastrointestinal duplication cysts. The clinical picture is usually characterized by epigastric pain, vomiting and palpable abdominal mass, which may present in other more frequent diseases. Diagnostic confirmation often requires complementary imaging exams and treatment is always surgical. We report the case of a 2 month-old girl, presenting with incoercible, non-bilious vomiting after feeding with an initial diagnosis of hypertrophic pyloric stenosis. After a more thorough investigation, she was diagnosed with a gastric duplication cyst in the pylorus region. A laparotomy was performed with complete cystic resection. The followup visits were uneventful with complete resolution of symptoms. Gastric duplication have less than 50 reported cases. When it is located in the pylorus, it presents with earlier symptoms, including in the neonatal period, simulating cases of pyloric hypertrophic stenosis, as in the case reported here. Clinical examination and imaging help to determine the most accurate diagnosis, allowing appropriate surgical treatment, avoiding future complications including malignant tumors.

Gastric duplication cyst fistulized with the colon in an adult: A case report

AbstractGastric duplication cyst is uncommon congenital malformation rarely seen in the adult population. Although complications related to duplication such as infection, haemorrhage, obstruction, and fistula formation with neighbouring structures had been previously reported, fistulization into the colon in adult has been previously never described to our knowledge. In this study, we present the case of a 36‐year‐old male patient with moderate mental retardation who presented with 10 months history of progressive abdominal pain, nausea, vomiting, and important weight loss. Clinical assessment and radiological investigations demonstrated the presence of non‐communicating gastric duplication cyst inserted on the greater curvature of the antrum and fistulized into the transverse colon. At laparotomy, the cyst was completely excised and the colon containing the fistula was resected with colo‐colonic anastomosis. Pathology confirmed gastric duplication and demonstrated that the inner surface of the cyst was lined by gastric type mucosa. The patient had an uneventful recovery and after 3 months of follow‐up, all symptoms disappeared. Also, he gained 11 kg in weight. This case highlights, therefore, the fact that all gastric duplication cysts should be removed in order to avoid the risk of serious complications.

Duodenal atresia type III showing distal bowel gas and atypical malrotation in association with gastric and bile duct duplications

Association of duodenal atresia (DA) with gastric duplication cyst is an extremely rare entity. Furthermore, DA type III with the presence of distal bowel gas is very rare. We report the case of a 13-day-old preterm male with neonatal intestinal obstruction. Radiological evaluation revealed duodenal obstruction at the second part with the presence of few distal bowel gas shadows. Laparotomy revealed dilated gastroduodenum, atypical malrotation, and a cystic structure (duplication cyst) identical to the stomach attached to its greater curvature along with type III atresia of the second part of the duodenum. Duodenotomies revealed the presence of bile along with air at either blind ends of the duodenum which could be explained by the presence of bile duct duplication at the distal end. We propose that this association is due to “defective mesenchyme formation during organogenesis,” which may explain multiple duplication abnormalities and DA.

Удвоение пищевода и желудка у детей

Considerable attention is currently being paid to the diagnosis and treatment of gastric malformations complicated by its obstruction. This can be attributed to stable incidence of these disorders among other congenital anomalies of the gastrointestinal tract and no clear understanding of the causes and mechanisms underlying the development of this pathology. Gastrointestinal duplications are rare congenital malformations that differ significantly in their appearance, location, size, and clinical manifestations. Their incidence is 1 case per 4,500 autopsies. Duplications can be cystic and diverticular (tubular) and can be located in any part of the gastrointestinal tract from the root of the tongue to the anal canal. The small intestine is affected most frequently, while duplications of the rectum, duodenum, and esophagus are exceedingly rare. In this article, we report two cases of gastrointestinal duplications in children treated using surgery. Key words: neonate, obstruction, developmental malformations, gastric duplication, esophageal duplication, case report

Gastric duplication cyst in an infant presenting with melena

Gastric duplication cyst in an infant presenting with melena

Gastric duplication cyst with multiple ectopic pancreatic tissues: A case report and review of literature

A gastric duplication cyst (GDC) is a type of enteric duplication cyst. It can co-exist with an ectopic tissue. This was a female toddler with a GDC at the greater curvature. An abdominal ultrasound and a contrast-enhanced computed tomogram suggested the cyst. She had laparotomy, complete cyst and partial gastric excision with the removal of extragastric pancreatic tissue. The histology report came out as a cyst with associated intracystic and an extracystic pancreatic tissue. She made a clinical improvement. GDC can be associated with both intracystic and extracystic ectopic pancreatic tissues. This should be kept in mind when choosing the modality of treatment.

A Case Report of Gastric Duplication Treated by Laparoscopic Resection

A Case Report of Gastric Duplication Treated by Laparoscopic Resection

Dynamic Compression-A New and Practical Technique for the Sonographic Diagnosis of Enteric Duplication.

This study aims to examine the utility of dynamic compression and other sonographic signs in diagnosing enteric duplication. This study reviewed real-time sonographic findings from ultrasound examinations performed by the author between April 2015 and March 2017, including 4 consecutive cases of enteric duplication and 7 cases of other abdominal cysts (control group). The ability of dynamic compression to separate the lesion from the adjacent intestine was analyzed, as were other sonographic signs, including the 5-layer sign, peristalsis, and the split-wall sign. The 5-layer sign and peristalsis were seen in only 1 of 4 cases of enteric duplication. The split-wall sign was positive in all 4 cases of enteric duplication. In a case of gastric duplication, the split-wall sign was not detected during the first examination. One case showed an atypical white split wall, and 3 cases showed a pseudo-split wall; however, this pseudo-split wall was differentiated from the true split-wall sign using dynamic compression. The dynamic compression technique correctly differentiated enteric duplication from other abdominal cysts in all but 2 cases (82%). The 5-layer sign and peristalsis were not sensitive for enteric duplication. The split-wall sign may have the highest sensitivity and specificity for enteric duplication, but finding this sign is technically difficult and interpretation is complicated by atypical variations. Dynamic compression differentiated enteric duplication from other abdominal cysts with 82% accuracy, and this technique was simple to perform and easier to interpret than the split-wall sign.

Gastric outlet obstruction due to gastric duplication cysts with heterotopic pancreatic tissue treated by marsupialization

Abstract Gastric duplication cysts are rare congenital anomalies often treated with complete surgical excision, but this is not always possible. In such cases, resection and reconstruction have been advocated, but this may lead to significant morbidity. We present a unique case of a 3-year old girl who presented with complete gastric outlet obstruction due to multiple gastric duplication cysts with heterotopic pancreatic tissue treated with marsupialization and endoscopic surveillance as an alternative to gastric resection and reconstruction. This approach avoids morbidities from a more extensive procedure and in this case, alleviated the obstruction, averted sequelae secondary to heterotopic pancreatic tissue, and provides surveillance in the rare case of malignant degeneration. The child tolerated the procedure well and has been symptom free for the past year.

Gastric duplication cyst with internal hemorrhage after trauma: A case report and literature review

Gastric duplication cyst with internal hemorrhage after trauma: A case report and literature review

A case of gastric duplication presenting as a retroperitoneal cystic lesion

Gastric duplication is a rare congenital anomaly accounting to 4% of all gastrointestinal tract duplications. It is usually diagnosed pre-natally or during infancy. Retroperitoneal gastric duplication is very rare in adult patients. It is generally asymptomatic or presents with non-specific symptoms. The sensitivity of classical imaging modalities for retroperitoneal gastric duplication is weak. Retroperitoneal gastric duplication could be misdiagnosed as other retroperitoneal cystic lesions and it could be definitely diagnosed by typical findings of abdominal enhanced computed tomography (CT) and endoscopic ultrasonography (EUS) plus EUS:guided fine needle aspiration biopsy in gastric duplicated cyst. A female adult patient was diagnosed by an exceptional hospital CT as retroperitoneal cystic lesion and was admitted in our hospital in March 2019. The abdominal enhanced CT in our hospital preoperatively indicated a cystic lesion above the left kidney and the maximum cross section was 9.0 cm×5.2 cm. Lymphocysts and others should be identified and the lesion might be from the stomach. The retroperitoneal gastric duplication was not diagnosed before operation. In the operation laparoscopy revealed the cystic lesion in the retroperitoneum. The pancreas, left adrenal gland, and left kidney were compressed by the cystic lesion. The top of the lesion was connected with the small curvature of the stomach, but it was not communicated with the stomach. The retroperitoneal cystic lesion was completely excised and the surrounding organs were not damaged. The retroperitoneal gastric duplication was clearly diagnosed by the findings in the operation and the pathology of the lesion. The patient was discharged a week after surgery without gastrointestinal and pancreatic injuries. Therefore, the differential diagnosis of retroperitoneal cysts should consider the possibility of retroperitoneal gastric duplication. For patients with typical CT findings or unclear boundaries between the tumor and the stomach wall, gastric duplication could be diagnosed by EUS plus EUS:guided fine needle aspiration biopsy in the cyst. Retroperitoneal gastric duplication cyst could be completely excised by laparoscopy through abdominal cavity and the stomach wall could be completely repaired.

Successful laparoscopic resection for gastric duplication cyst: a case report

BackgroundGastric duplication is a relatively rare congenital malformation, accounting for approximately 2.9–3.8% of gastrointestinal duplications. Gastric duplication cyst is a congenital anomaly that is rarely observed in adults. Accurate diagnosis of these cysts before resection is difficult. In this report, we describe a patient with gastric duplication cysts that were treated by laparoscopic resection.Case presentationA 46-year-old Japanese woman was referred to our institution because a cystic lesion in the pancreatic tail was detected by ultrasonography during a health examination. The lesion had a clearly defined boundary of approximately 40 mm. A thick cystic lesion of the septum was observed in the pancreatic tail, but invasion into the stomach wall was not recognized on a computed tomographic scan. Endoscopic ultrasonography revealed that the tumor appeared smooth with a marginal edge, which was characterized by echo with high homogeneity, and the presence of viscous mucus was suspected. The preoperative diagnosis of mucinous cystic neoplasm was the reason for laparoscopic tumor resection. The resected specimen was a smooth surface tumor, and it was full of mucus. Histopathological study revealed that the mucosa was covered with crypt epithelium, muscularis mucosae, intrinsic muscularis, and serosa, and the wall of the tumor had a structure very similar to that of the stomach wall. The mucosa was partially drained by intrinsic gastric glands, but most of them were denucleated. No pancreatic tissue was present, and the tumor had no continuity with the spleen. These findings indicated a diagnosis of gastric duplication cyst with no continuity with the stomach wall.ConclusionsIn our experience, it is difficult to differentiate gastric duplication cyst from mucinous cystic neoplasm before laparoscopic resection. Events such as infection, bleeding, perforation, ulceration, fistula formation, obstruction, and compression have been linked to gastric duplication cysts, and malignant transformation of these cysts has been reported. Therefore, we suggest that resection should be the first treatment option for gastric duplication cysts.

Duplicación digestiva múltiple: estómago y duodeno con tejido pancreático ectópico

Intestinal duplications are congenital anomalies representing cystic or tubular lesions that can be found in any segment of the digestive tract. They are in the mesenteric border of the compromised segment with which they share irrigation. They are of rare occurrence and of multiple embryological etiology. The three essential factors for diagnosis include being surrounded by smooth muscle, sharing a common wall, and having mucous from the place of origin. Multiple duplications occur in 15% of duplications and are frequently associated with skeletal, digestive, and genitourinary tract malformations. We present the case of a pediatric patient with a rare multiple duplication of the digestive tract that includes gastric and duodenal duplication with pancreatic ectopic tissue, which represented a challenge for diagnosis and therapeutic management.

Gastric duplication cyst in an adult with autoimmune hemolytic anemia: a case report and review of the\xa0literature

BackgroundGastric duplication cysts are uncommon congenital anomalies found primarily in children and rarely seen in the adult population. Accurate diagnosis of cysts before resection is difficult even using the most advanced imaging techniques.Case presentationIn this report, we describe a 28-year-old Moroccan patient with a history of autoimmune hemolytic anemia who presented with an asymptomatic abdominal cystic mass detected during abdominal computed tomography performed before splenectomy. Magnetic resonance imaging performed for accurate characterization showed a high-signal-intensity cystic mass on T2-weighted images, located between the patient’s stomach and spleen. The patient underwent a complete cyst resection during exploratory laparotomy. The histological examination showed a cyst lined by three different epithelia with bundles of smooth muscle, which suggested a gastric duplication cyst.ConclusionsWe report a case of gastric cyst duplication in an adult with autoimmune hemolytic anemia, and we discuss this rare association, radiological findings, and the unique histological findings of this case.

GASTRIC DUPLICATION CYST: A RARE CONGENITAL ANOMALY

Gastrointestinal (GI) duplication is defined as a spherical structure, with a muscular coat lined by a mucous membrane in the alimentary tract is a rare congenital anomaly. In this report, we present a case of a 14-year-old male child with complaints of epigastric pain for 1 month. Computed tomography scan of the abdomen was suggestive of two cystic lesions in the stomach. Exploratory laparotomy was performed with excision of cysts. Histopathology of both cysts was suggestive of gastric duplication cyst.

Gastric Duplication Cyst Associated with Esophageal Atresia and Anorectal Malformations: A Rare Association

Esophageal atresia (EA) and tracheoesophageal fistula (TEF) and anorectal malformations (ARM) in a newborn usually present with frothing of saliva and massive abdominal distension rendering it difficult to diagnose associated intrabdominal pathologies. We report a large gastric duplication (GD) cyst in a 2-day-old neonate with EA and TEF. GD cyst was detected in the early post-operative period as the abdominal distension persisted after repair of EA and TEF. The baby underwent excision of GD cyst with good outcome thereafter.

Gastric duplication in infants

Clinicians pay close attention to the questions related to the diagnosis and treatment tactics of stomach defects with its obstruction in view of their stable frequency and lack of consensus on these diseases development mechanisms. The insufficient individual experience of every clinician leads to the difficulties in early diagnostic and the most adequate surgical intervention choice, and so, high rates of mortality. Purpose of the work. Improvement of the diagnostic and treatment tactic in infants with gastric duplication. Materials and methods. Clinical experience of two cases of the newborn children treatment with rare variants of digestive tract developmental defects is presented. In one child it was a case of stomach cystic duplication; and the other had a cystic duplication of stomach and duodenum. Results. There have been 5 cases of the stomach duplication treatment in the last 5 years in the Pediatric Surgery Clinic of Zaporizhzhia State Medical University. Two children were diagnosed with this pathology in neonatal period. Clinical analysis of these cases is described in the article. Both infants have undergone the early operative intervention. Type and extent of the operation depended on the peculiarities of localization, sizes, clinical signs of the defects and the general state of patients. The main stages and methods of medical-diagnostic process of such patients’ management are presented. Conclusions. The analysis shows that the efficacy of stomach obstruction rare forms diagnosis is achieved by usage of algorithms based on the staged modern diagnostic methods, taking into account their resolution and congenital anomaly type. In congenital stomach and duodenum duplication maximal informativness can be achieved using ultrasound and CT (or MRI) of the abdominal cavity. The most effective and non-invasive is ultrasound method by high-resolution devices. The discussed clinical cases are examples of early diagnosis of the stomach duplication and the right choice of active tactics for such children management that has made it possible to obtain a successful treatment outcome.