Gastrointestinal Tract Duplications Research Articles

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.

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.

DUPLICATION OF THE SMALL INTESTINE IN EMERGENCY PEDIATRIC SURGERY

Duplication of the gastrointestinal tract is a rare congenital surgical malformation. The frequency of the anomaly is 1:4500 ofnewborns, the most frequent localization of the duplication is the iliac region of the small intestine – 33%, duplications of the jejunum make up 7-10% of the total number of cases. The complexity of diagnosis and choice of surgical tactics is due to the absence of specifi c symptoms, possible asymptomatic presence for a long time, clinical manifestations characteristic of other diseases. The article presents an example of a clinical case of doubling of the jejunum in a pediatric patient complicated by peptic ulcer and diff use peritonitis. Complaints, features of the diagnostic process at the prehospital stage, selected surgical tactics, and causes of complications were analyzed.Morphologic signs of jejunal duplication are given. The given clinical example proves that the cause of dyspeptic phenomena of long duration and abdominal pain of unknown origin in pediatric patients may be surgical pathology, in particular, doubling of the gastrointestinal tract complicated by infl ammation of the small intestine. Therefore, such patients need the consultation of a pediatric surgeon, search and detection of possible surgical pathology, including doubling of the intestine. The diagnostic methods for detecting this anomaly are radiography, ultrasound, and contrast- enhanced computed tomography (CECT). Perforation in GI duplication is one of the causes of peritonitis that should be considered by emergency pediatric surgeons in their practice. Timely determination of the patient’s gastrointestinal tract duplication allows the emergency surgeon to optimize diagnostic measures, optimal choice of surgical approach, predict the volume of surgical intervention, avoid possible complications, reduce the time and cost of treatment. Since the fi nal confirmation of the diagnosis of gastrointestinal tract duplication is the result of morphological examination, its performance is mandatory.

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.

Laparoscopic cyst enucleation is a promising technique for treatment of gastrointestinal tract duplications in children

BackgroundLaparoscopic cyst enucleation has its advantages and limitations in treatment of gastrointestinal tract (GIT) duplications. It allows to avoid bowel resection in such locations as ileocecal valve. We introduced laparoscopic cyst enucleation with further bowel plasty using cyst muscle layer and without monopolar coagulation, for cyst dissection we used straight scissors. Materials and methodsOur study included 20 children with GIT duplications, who underwent cyst enucleation from 2018 to 2021. Laparoscopy was performed in all cases with various cyst locations (stomach – 2, duodenum – 3, small bowel – 14, ileocecal area – 1). Mean age of surgery was 40 ± 35,3 days (min 6 days, max 150 days). ResultsMean operation time was 84,4 ± 27,35 min (min – 40 min, max – 160 min). We had no intraoperative complications. All patients received parenteral feeding for 3–5 days after the operation. Postoperative complications occurred in 3 cases: bowel perforation which required enterostomy (10%) and bowel volvulus required resection (5%). To our opinion, perforations occurred due to monopolar coagulation used for cyst enucleation in these children. No complications were observed in patients who underwent enucleation by straight scissors. Mean postoperative hospital stay was 15.6 ± 10.48 days (min – 4 days, max – 58 days). We observed neither stenosis nor any other complications in the long-term follow-up. ConclusionsLaparoscopic cyst enucleation is a feasible and safe approach for GIT duplications. It allows to avoid bowel resection, and the use of straight scissors instead of monopolar coagulation provides less postoperative complications such as perforation. The Level of evidenceIII.

Gastrointestinal Tract Duplications in Children: A Tertiary Referral Center Experience.

Objective:Gastrointestinal duplications are rare congenital anomalies. Herein, we present a single institutional experience in pediatric gastrointestinal tract duplications.Methods:Patient records from 2014 to 2019 were retrospectively evaluated for demographic data, clinical presentation, diagnostic methods, surgical findings, and pathological reports.Results:This study included 19 patients, of whom 10 were males and nine were females, with a median age of 30 (21 days-15.5 years) months. Three patients were antenatally and three were incidentally diagnosed. Abdominal pain, vomiting, constipation, and perianal accessory orifice were the most common presenting symptoms. Preoperative diagnostic workup included ultrasonography (n=13), cross-sectional imaging (n=8), and nuclear scintigraphy (n=1). A preoperative diagnosis was possible in 14 (74%) patients. The duplications originated from the foregut in seven (37%) patients, midgut in seven (37%), and hindgut in five (26%). Cystic duplications were observed in 14 (74%) patients and tubular in five (26%). The total surgical excision with (n=8) or without (n=10) associated organ resection was possible in 18 patients. Partial cyst excision with a complete mucosal removal was done in 1 patient. Heterotopic mucosa was present in six (32%) specimens. The respiratory origin with thyroid transcription factor-1 positivity was contained in two para-esophageal duplications. Among five patients with heterotopic gastric mucosa, 1 had presented with perforation and the others with hemorrhage.Conclusions:Duplications may involve any gastrointestinal segment. The clinical presentation is highly variable because of the wide variation in the involved segment and sizes and the possibility of bearing heterotopic mucosa. The surgery aims to totally excise the cyst or at least totally remove the inner mucosal lining.

GASTROINTESTINAL DUPLICATION CYST: A MASQUERADER

AIM: Gastrointestinal tract (GIT) duplications are rare congenital anomalies found in 0.2% of the children, most detected ante-natally or within rst two years of life. We report three cases with an aim to study the clinical and histopathological ndings. METHODS: RESULTS It is a retrospective analysis of the paediatric patients with gastrointestinal tract duplication over a period of ve years. : Two cases, 11 year and 4 month old males diagnosed as ileal duplication cyst presented with abdominal pain and respiratory distress respectively. Third case of a newborn female on prenatal ultrasonography showed CCAM, was eventually diagnosed as foregut duplication cyst on histopathology. All three cases were managed surgically. GIT duplications, CONCLUSION: although rare can arise anywhere along the GIT. Clinical scenario is diverse and mimics other intra-abdominal conditions thus presenting a great challenge to arrive at a diagnosis preoperatively. Therefore high index of suspicion and histopathology is must for the correct diagnosis and management.

Tubular ileal duplication causing small bowel obstruction in a child

Gastrointestinal duplications are rare congenital abnormalities that has been rarely reported, accounting for 0.01% of live births cases. Despite medical tests and radiological examinations, the diagnosis could be made during the operation. It is difficult to diagnose and prime to be aware of variants, manage such challenging case in emergency setting. We present a case of 9 yrs old girl child, Patient with duplication of gastrointestinal tract (ileal-tubular type) presenting as acute intestinal obstruction who underwent an exploratory laparotomy and resection –anastomosis done. The initial diagnosis and surgical management of such patient is challenging due to very rare congenital anomalies and atypical presentation in emergency setting. A high index of suspicion is required for diagnosis. It is important to be aware that common presentations in the emergency room like intestinal obstruction, perforative peritonitis and complicated appendicitis may be manifestations of an underlying enteric duplication cyst when another more common source cannot be identified.

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.

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.

УДВОЕНИЕ ТОЛСТОЙ КИШКИ, ОСЛОЖНЕННОЕ ОСТРОЙ КИШЕЧНОЙ НЕПРОХОДИМОСТЬЮ, У ДЕВОЧКИ 9 ЛЕТ

Gastrointestinal tract (GIT) duplication is a rare congenital anomaly with an incidence of about 1 in 4,500 newborns. Duplication of the intestine, as a rule, is diagnosed at 2–3 years, however, cases of this pathology being detected in patients of any age are described. Duplication of GIT can be asymptomatic or be detected when massive intestinal bleeding, intestinal perforation, obstruction due to intussusception or volvulus, and even malignancy in the doubled section occur. The characteristic signs of a duplication of the intestine are a well-developed muscular membrane, a general blood supply to the duplication with a portion of the supporting intestine, the presence of a mucous membrane that coincides with the supporting segment, in a third of cases, ectopic tissue is found. Our article describes the staged treatment of a patient with total tubular colon duplication complicated by acute intestinal obstruction.

Rectal Duplication Cyst Mimicking Rectal Prolapse

Gastrointestinal tract duplications are rare congenital malformations that are benign, presenting usually in childhood. Mostcommon sites include the distal ileum and oesophagus. Rectal presentation is quite uncommon and is usually cystic. Thisis a case of a three year old boy who came with rectal prolapse. On further examination and imaging investigations a presacralcyst was located and a diagnosis of rectal duplication was made. The cyst was completely excised by a posteriorsagittal approach.

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.

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.

Pyloric Duplication in Ten Years Old Girl: A Case Report

Gastrointestinal duplication cysts are rare congenital anomalies. Pyloric duplication represents 2.2% of all gastrointestinal tract duplications. The presentations merely depend on the site of occurrence, size and type of the cyst, and presence of ectopic mucosal lining. A ten years old girl vomited for two months, accompanied with stomach ache and difficulty in defecation. The color of stool sometimes was black. The body weight decreased twelve kilograms in two months. On physical examination, no abdominal distention and no palpable mass was found, bowel sound was decreased and there was tenderness in epigastric area. Nutritional status of patient was severe malnutrition. Laboratory test revealed mild hypochromic microcytic anemia, severe hyponatremia, severe hypokalemia, and hypoalbuminemia. Abdominal ultrasound revealed thickening of the gastric wall and upper gastrointestinal contrast study revealed partial stenosis with thickening of pyloric wall. Esophagogastroduodenoscopy revealed multiple gastric ulcers and gastric outlet obstruction. Cyst duplication and stricture in the pylorus were found during surgical procedure. The pediatric surgeon performed an excision of duplication cyst and gastroduodenostomy side to side anastomosis. Histopathologic examination from cyst confirmed the enteric duplication cyst. The patient was discharged in good condition. We concluded that pyloric duplication is considered as one of the differential diagnosis in children with symptoms of gastric outlet obstruction. Appropriate surgical procedures should be undertaken to avoid complications.

Çocuklarda Sindirim Sistemi Duplikasyonlarında Minimal İnvaziv Yaklaşım

Çocuklarda Sindirim Sistemi Duplikasyonlarında Minimal İnvaziv Yaklaşım

Clinical characteristics of gastrointestinal tract duplications in children: A single-institution series review.

Due to the various presentations of gastrointestinal tract duplications (GTD), diagnosing and management for this disease might be varied and difficult. We intend to improve the experiences for these difficult, in terms of the clinical presentations, diagnostic investigations, management.We reviewed recent literature and retrospectively analyzed 72 pediatric patients with enteric duplication. Diagnosis was confirmed by surgery and pathological examination for imaging characteristics and clinical and pathological features.The ages of patients ranged from one month to 12.5 years. The clinical presentations of the patients included 57 cases with abdominal pain, followed with nausea or vomiting, abdominal distension, etc. All of the patients were diagnosed by ultrasonography, and most of them presented as intra-abdominal cystic masses. Four cases were diagnosed with the cysts other than GTDs, like, mesenteric cyst, chledochal cyst and abscess, and so on. Computed tomography was performed on 65 patients. X-rays and barium meal showed the outline of the cyst structure, with intestinal displacement due to the pressure from the cyst. Among the 72 cases of enteric duplication, 45 were located with ileocecal area, 41 were ileal and 8 were colonic duplications.Enteric duplication is very rare in children and is prone to misdiagnosis. The preoperative diagnosis of enteric duplication can be improved through comprehensive analysis of various imaging exams and closely related clinical presentations.

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.

Intestinal duplications: incidentally ileum duplication cyst in young female

Gastrointestinal tract duplication is a rare congenital malformation in young patients and in adults, that occur anywhere from the mouth to the anus and their macroscopic structure may be cystic or tubular.Intestinal duplication does not show specific symptoms, indeed they can present with a variety of symptoms including abdominal distension and pain, sickness, hemorrhage, chronic respiratory disorders, as well as non-painful abdominal mass. Nonetheless, intestinal duplication can remain completely asymptomatic and be diagnosed as an incidental finding. Presentation with acute complications such as intestinal invagination or mechanical occlusion is quite rare.We present a case of asymptomatic ileum duplication cyst in young female who referred to the emergency department for trauma and was screened by eco-Focus Assessment Sonography for Trauma (eco-FAST), followed by MR and CT.The patient underwent ileal resection and prophylactic appendicectomy with ileo-cecal termino-lateral anastomosis. In this case, the intestinal duplication cyst was an asymptomatic incidental finding.

Trudności diagnostyczno-lecznicze zdwojenia jelita grubego – opis przypadku

Duplication of the gastrointestinal tract is a rare congenital malformation that can occur throughout the length of the digestive tract. The duplication of the colon on a long section connected with the light of the digestive tract is a relatively rare form of gastrointestinal tract duplication. This defect is a difficult diagnostic and therapeutic problem due to non-characteristic symptoms. Imaging diagnostics allows to correctly recognize gastrointestinal duplication in only 25% of cases. The authors present the case of a girl who was hospitalized many times at the Department of Pediatric Surgery due to recurrent abdominal pain of various types character. Variable clinical symptoms and diagnostic difficulties have caused delay in making a diagnosis of tubular double colon. The final diagnosis was made only after two computed tomography, which was performed due to the rapidly deteriorating and unclear patients condition. The postoperative period after resection of the double intestine proceeded with a wide spectrum of complications that required long-term hospitalization. Duplication of the colon is a difficult diagnostic problem. Non-characteristic symptoms and unclear imaging results delay the diagnosis and expose the patient to complications.