Gastrointestinal Duplication Cysts Research Articles

True pylorus duplication: a case report

True pylorus duplication cysts are particularly rare, the literature describes only a small number of cases. They account for nearly 2.2% of all alimentary tract duplications. Most of the gastric duplications presents at an age younger than one year with one-third diagnosed in the neonatal period. However, they are not limited to that period. We report a case of a true pyloric duplication cyst in a 3-year-old girl who had been experiencing frequent vomiting with occasional abdominal pain for about 15 days prior to her presentation. The patient had an abdominal ultrasound that showed an epigastric cystic mass. CT of the abdomen demonstrated a 3.8×3.8 cm mass with a claw sign proximal to the first part duodenum. The diagnosis of pyloric duplication cyst was confirmed during the operation and with the histopathological examination following the resection. The patient is doing well with an appropriate weight gain at the follow-up appointments. The patient is doing well with an appropriate weight gain at the follow-up appointments. In summary, this is an an unusual case of gastric outlet obstruction that presented outside the usual age period caused by a pyloric duplication cyst. Imaging studies including US and CT are useful aids in the diagnoses of gastrointestinal duplication cysts.

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.

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.

Congenital heterotopic gastrointestinal duplication cyst of the face: a rare case report

Gastrointestinal duplication (GDC) cysts have various synonyms; choristoma, enterocystoma, and duplication cyst. They are infrequent congenital benign lesions diagnosed mainly in children in the first decade of life, comprising approximately less than 5% of the pediatric population with a predilection for the male sex. It is exceedingly rare in the oral cavity but it is possible, particularly on the tongue, floor of the mouth, and pharynx. From 1895 until 1994, 30 cases of this lesion in the oral cavity were reported. Nowadays, none of the authors reported a GDC in the facial region. We report an exceptional case of heterotopic gastrointestinal duplication cysts (HGDC) in the facial region of a 13 -years -old male teenager who was referred to our medical department for an evaluation of a painless progressive facial asymmetry. In the first instance, the ultrasound facial soft tissue was made with a 6.5 MHz convex transducer, reporting a big anechoic image with regular borders to a 60 x 26 x 56 mm diameter with a 46cc approximate volume. Following this, a non-contrast magnetic resonance image was executed with an open Philips PanoramaⓇ machine performed at 3T, reporting a hyperintense image in T2-weighted (repetition time msec/echo time msec: 5,500/112) sagittal sequence and FLAIR-weighted (5,714/80) axial sequence; and an isointense image in T1-weighted (24/80) coronal sequence to 54 x 30 x 51 mm diameter compatible with space occupant lesion with interior walls. A complete tumor resection was achieved under balanced general anesthesia, and the specimen was sent for histological examination. Microscopic examination showed a cystic cavity lined mostly by mucous secretory gastrointestinal epithelium and other areas by stratified squamous epithelium. The cystic wall was composed of fibrous connective tissue and contains abundant gastric cells. Its deepest portion exhibits a smooth muscle layer. In summary, HGDC is an unusual congenital head and neck lesion, but it should be considered in the differential diagnosis of neonates and children. The diagnosis of gastrointestinal tract duplications may be suggested by imaging studies; however, the correct diagnosis is defined by histopathologic analysis. Due to the risk of destruction potential and malignant transformation, HGDC should be treated surgically by complete excision.

Duplication Cysts and Autoimmune Hemolytic Anemia: An Association or a Coincidence?

Duplication cysts are rare congenital anomalies of the gastrointestinal tract and the occurrence of multiple such cysts is an extremely rare occurrence. Autoimmune hemolytic anemia is an extremely unusual manifestation of these duplication cysts. Herein, we report a case with two duplication cysts (one cyst in the thorax; another in the abdomen) complicated with autoimmune hemolytic anemia. This patient was a five year-old-male child who presented with congestive cardiac failure due to severe anemia (which, on evaluation, was diagnosed as autoimmune hemolytic anemia). Imaging studies (chest radiograph and computed tomography) revealed duplication cysts in the chest and abdomen. Anemia flare-up was noted in the patient despite two months of prednisolone therapy (2 mg/kg/day) and two high dose intravenous methylprednisolone pulse therapy courses (30 mg/kg/day for 5 days each). The steroid refractory autoimmune hemolytic anemia responded to rituximab (375 mg/ m2 body surface area/week for 4 weeks). Four months after tapering off the steroid therapy, the patient did not experience flare-up of the anemia. To the best of our knowledge, this is the youngest and first pediatric age group patient to be reported, with a possible association between gastrointestinal duplication cysts with autoimmune hemolytic anemia.

Laparoscopic resection of an intra-abdominal esophageal duplication cyst in the ileum: a case report.

Esophageal duplication cyst (EDC) is a type of gastrointestinal duplication cyst that involves congenital malformations of the gastrointestinal tract. EDCs are frequently found in the mediastinum and thoracoabdominal region, but rarely occur in the abdominal cavity. However, intra-abdominal EDCs are frequently found in the upper abdomen near the abdominal esophagus. Here, we report, for the first time, a case of intra-abdominal EDC that occurred in the ileum. A 14-year-old female patient presented to our hospital with complaints of epigastric pain and vomiting. Abdominal computed tomography (CT) revealed a cystic tumor in the pelvis, suspected of ovarian origin. She was admitted to our gynecology department and underwent emergency surgery. The laparoscopic examination revealed that both ovaries were intact and that a primary tumor had developed from the ileal mesentery. Since the patient's condition was not urgent at the time of the gynecological surgery, the procedure was completed by only performing exploratory laparotomy; the patient was admitted to our department after the surgery. Pelvic magnetic resonance imaging performed on the next day revealed a cystic mass measuring 90 × 65mm with a smooth margin and homogeneous signal intensity, arising posterior to the uterus. The mass was suspected as an intestinal duplication cyst. On another day, after the examinations were completed, we resected the portion of the small intestine containing the tumor by laparoscopy. The patient had a successful postoperative course and was discharged on the 5th postoperative day. Histological examination showed that the cyst was lined by stratified squamous epithelium, contained esophageal glands, and had a two-layer muscularis propria. Therefore, a diagnosis of intra-abdominal EDC was performed. An intra-abdominal EDC cyst is relatively rare; this is the first case reported at the distal ileum.

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.

MID ILEAL DUPLICATION CYST WITH ECTOPIC GASTRIC MUCOSA DETECTED BY TECHNETIUM-99M PERTECHNETATE

Gastrointestinal duplication cysts are a rare congenital malformation in the gastrointestinal tract, most commonly seen in the ilium. The present study reported a child with a mid ileal duplication cyst ofthe ectopic gastric mucosa that was diagnosed by Technetium-99m pertechnetate single-photon emission computed tomography-computed tomography (SPECT-CT) scintigraphy. Gastrointestinal duplication cysts can present with massive lower gastrointestinal bleeding in early childhood Technetium-99m pertechnetate (Meckel scan) with SPECT-CT can help reach the diagnosis and decrease morbidity and mortality.

Esophageal Duplication Cysts in 97 Adult Patients: A Systematic Review.

Esophageal duplication cysts are a rare congenital cystic malformation from faulty intrauterine recanalization of the esophagus during the 4-8th weeks of development. They account for 20% of all gastrointestinal duplication cysts and commonly involve the distal esophagus. Presenting symptoms may be related to size and location. Following the PRISMA guidelines, a systematic review was performed by searching published literature in various databases. Data from 97 reported case reports were pooled to present a descriptive and statistical analysis. Patient population was composed of 51(52.5%) males and 46 (47.5%) females, and mean ages was 42.3years (18-77). Distal cysts were the most prevalent. Seventy-nine (81.4%) patients were symptomatic; common symptoms included dysphagia, chest pain, cough and weight loss. Fifteen (15.5%) patients were treated conservatively and 75 (84.5%) by surgical treatment, among them thoracotomy in 30 (30.9%) patients and VATS in 17 (17.5%) patients. Mean length of hospital stay was 8.6days (range: 1-26days). One fatality was registered. Location, unlike size, was not found to influence presenting symptoms or treatment employed. Frequency of conservative treatment was not significantly different between symptomatic and asymptomatic patients. Open approaches were associated with longer stays than their minimally invasive counterparts. Esophageal duplication cysts remain rare in adults and are frequently located in the distal esophagus. Larger cysts are more likely to cause symptoms. Various surgical techniques may successfully be employed in the treatment of this pathology. Minimally invasive procedures have a shorter hospital stay.

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.

Pancreatic ductal adenocarcinoma in a patient with pancreas divisum and gastrointestinal duplication cyst: a case report

BackgroundThe complication of duplication of alimentary tracts and pancreas divisum (PD) is a rare malformation and the development of pancreatic ductal adenocarcinoma (PDAC) in this malformation is also extremely rare. There have been some reports of complication of malignancy in a gastric duplication cyst (GDC) and PD. However, there have been no reports of complication of PDAC in cases with GDC and PD.Case presentationA 54-year-old woman was followed up at the previous hospital due to a history of ovarian endometrial adenocarcinoma. She also had a surgical history of partial excision for a GDC and pancreatic tail of PD in her childhood. A gynecological follow-up computed tomography (CT) examination revealed the pancreatic body tumor and the bifurcated main pancreatic duct dilatation. Furthermore, magnetic resonance cholangiopancreatography also revealed that the ventral main pancreatic duct communicated with the GDC. The initial levels of tumor markers were high, but we could not achieve preoperative histopathological diagnosis. The preoperative diagnosis was PDAC occurring in a case with PD and GDC. She received two courses of neoadjuvant chemotherapy with gemcitabine and nab-paclitaxel. A CT examination after neoadjuvant chemotherapy revealed the shrinkage of the tumor, and then we performed distal pancreatectomy with splenectomy and GDC resection. A histopathological examination revealed invasive PDAC and lymph node metastases; pathological staging was T1N1M0, stage III. Furthermore, PD and GDC were also histopathologically detected. The postoperative course was uneventful, and she was discharged on the postoperative day 25. She received S-1 monotherapy for 6 months, and no recurrence has been detected at 1 year after radical resection.ConclusionsWe herein presented an extremely rare combined case of PD, GDC and PDAC. We successfully treated it by neoadjuvant chemotherapy and distal pancreatectomy with GDC resection, and postoperative chemotherapy.

Gastrointestinal duplication cysts: what a radiologist needs to know.

Gastrointestinal tract duplication cysts are rare congenital malformations which can be diagnosed as early as the prenatal period but are frequently found in infancy or incidentally in adulthood. They can be seen throughout the alimentary tract with the most common involving the distal ileum and second most common the esophagus. Many duplication cysts are asymptomatic and thus discovered as an incidental imaging finding, though they can also be symptomatic with an array of clinical presentations dependent largely on their location. The vast majority of duplication cysts are benign; however, there are rare instances of malignant transformation reported. The aim of this review is to show how multimodality imaging can help in the diagnosis of duplication cysts at various anatomical locations. Duplication cyst can become symptomatic and in rare cases undergo malignant transformation; therefore, they are typically managed with surgical excision, particularly if found prenatally or during infancy. Given the diversity of anatomic locations, multiple differential diagnoses, and the need for surgical intervention, it is valuable to comprehend the role of multimodality imaging role in diagnosing duplication cysts.

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.

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.

Imaging and differential diagnosis of gastrointestinal duplication cyst: A case report of newborn female and review

Imaging and differential diagnosis of gastrointestinal duplication cyst: A case report of newborn female and review

Gastrointestinal duplication cysts: experience from a tertiary care center in North India and review of literature

Background: Duplication cysts (DC) are uncommon congenital malformations which predominantly present in infants and young children. Owing to their variable clinical presentation, radiology and/or histopathology are often required to clinch the diagnosis. We present a case series of 66 patients, which is the largest series reported so far.Methods: A search of prospectively maintained institutional database was carried out to identify patients who were diagnosed and operated for gastrointestinal DC between January 2013 and August 2018. For all cases, the demographic data, site of DC, details of clinical presentation, associated conditions and histopathology findings were recorded. The slides of all cases were retrieved and re-examined.Results: The age range was 1 day to 47 years, with a slight male predominance (1.3:1). Ileum was the most common site followed by jejunum. Ectopic mucosae noted were gastric, pancreatic, biliary and respiratory. One case showed glial heterotopia. Perforation, gangrene and intussusception were among the co-existing pathologies noted.Conclusions: Duplication cysts are rare congenital malformations. The variability in clinical presentation makes the diagnosis elusive. Timely diagnosis and appropriate management require a high index of suspicion and a holistic diagnostic approach with clinical, radiological and histopathological inputs.

Gastrointestinal duplication cyst resulting in abdominal obstruction, pancreatitis, and intractable vomiting

Abstract Gastrointestinal duplication cysts are rare congenital anomalies that typically present with symptoms of abdominal obstruction. We present a 3-year-old female with recurrent episodes of emesis who was eventually diagnosed with a gastrointestinal, likely duodenal, duplication cyst. The diagnosis was delayed as providers initially attributed symptoms to more common diagnoses resulting in vomiting. Gastrointestinal duplication cysts should remain on the differential in a young child with symptoms of unexplained intestinal obstruction.

A Rare Case of Cecal Duplication Cyst—a Case Report

Duplication cysts of the intestine are a rare clinical entity, usually diagnosed in infancy or childhood. Cecum is the least common site of gastrointestinal duplication cysts. We are presenting a case of non-communicating cecal duplication cyst in an adult female. The cyst was excised completely laparoscopically without compromising the blood supply to the adjacent cecum. Histopathology confirmed the diagnosis. Non-communicating cecal duplication cysts can be excised without compromising the vascularity but communicating duplication cysts mandate a segmental resection of the part of the bowel involved.

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.

Pyloroduodenal duplication cyst presenting like hypertrophic pyloric stenosis

Gastrointestinal duplication cyst is a rare congenital anomaly. When it involves the pylorus or the first part of the duodenum, it may present with features of gastric outlet obstruction. We present a 4-month-old baby girl, second of a set of twins who presented with features of gastric outlet obstruction. A diagnosis of gastric outlet obstruction querying hypertrophic pyloric stenosis was made and she was resuscitated. The intraoperative finding was that of a huge non-communicating duplication cyst involving the pylorus and the first part of the duodenum. Excision and mucosal stripping of the cyst was done. Histology showed ectopic gastric mucosa. Pyloroduodenal duplication cyst is a rare congenital anomaly of the gastrointestinal tract and a close differential for patients who present too early or too late with features of Hypertrophic pyloric stenosis.