Ileal Duplication Cyst Research Articles

Intestinal Obstruction due to Ileal Duplication Cyst and Malrotation in a Preterm Neonate

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Intestinal Obstruction due to Ileal Duplication Cyst and Malrotation in a Preterm Neonate.

The baby was born to a 24-year-old primigravida mother by cesarean section at 36 week gestation and weighed 2420 grams. Antenatal scan at 32 week gestation showed dilated bowel loops and polyhydramnios (Amniotic fluid index: 32 cm) suggestive of intestinal obstruction. He developed respiratory distress soon after birth and was referred to our unit. On examination, the baby had respiratory distress with RR of 72/min. and sub costal retractions. Abdomen was distended at birth and baby had 120 ml of bilious aspirate in the first 14 hours of life. X-ray of abdomen showed dilated proximal bowel loops with absence of gas in distal bowel loops suggestive of intestinal obstruction. A provisional diagnosis of intestinal atresia was made. Laparotomy showed duplication cyst measuring 6 cm in diameter along the antimesenteric border involving proximal ileum and malrotation of small bowel (Fig. 1) Duplication cyst along with adjoining portion of ileum measuring 13.5 cm was resected and end to end anastomosis was done. Ladd’s procedure was done for malrotation. Histopathology showed the cyst attached to serosal aspect on the anti-mesenteric side without communication with ileum, but had a common muscular wall lined with simple columnar epithelium consistent with ileal duplication cyst. Baby was fed from the 7th day and was discharged uneventfully on the 14th postoperative day.

回腸重複腸管が捻転絞扼した緊急手術の1例

回腸重複腸管が捻転絞扼した緊急手術の1例

Intussusception secondary to a noncommunicating duplication cyst on the antimesenteric border of the ileum: A case report with a review of the literature

Gastrointestinal duplication cysts are uncommon congenital malformations that could present diagnostic and therapeutic challenges. They may be either cystic or tubular, and most of them are located in the mesentery of the intestine. Duplication cysts can be a diagnostic dilemma to the surgeon because of their varied presentations. A high index of suspicion is necessary to facilitate the diagnosis and prompt operative intervention after adequate resuscitation may be necessary in a setting where diagnostic tests are either not available or affordable. We report a case of a noncommunicating ileal duplication cyst in an infant presenting with intussusception, which was successfully managed by surgery.

A Rare Cause of Intestinal Obstruction in Infants: Ileum Duplication Cyst and Literature Review.

Cases of neonatal gastrointestinal system (GIS) obstruction are quite complex for pediatric surgery clinics. A rare cause of intestinal obstruction is the duplication cyst (DC). A three-day-old male patient presented at our clinic with a history of abdominal distension and bilious vomiting on the second day following birth. Although pathology had not yet been determined from observation and examination, surgery was performed when the patient could not tolerate oral feeding. An ileal DC forming an incomplete obstruction was observed. Ileoileal anastomosis was performed on the patient. Because DCs can present with different clinical symptoms, it is quite difficult to diagnose them in neonate patients. Lacking an imaging method that can provide an exact diagnosis, the diagnostic laparotomy is a suitable approach for both diagnosis and treatment to avoid delays in treatment.

Enteric duplication cysts in children: A target in algorithm for evaluation of lower gastrointestinal bleeding

Lower gastrointestinal bleeding (LGIB) in infants and children is a difficult diagnostic problem largely due to limitations of small-bowel evaluation. Duplication cysts are rare congenital malformations with variable clinical presentation. This report describes seven children (five boys, two girls and median age 10 [1.5-124] months) with ileal duplication cysts who presented with LGIB of varying severity from stool occult blood positivity with anemia to fresh bleeding per rectum. Diagnosis was made by Tc(99m) pertechnetate scan (n-5), balloon enteroscopy (n-1), and at laparotomy (n-1). Ultrasonography and barium meal follow-through missed the diagnosis in six and three cases, respectively. All cases underwent surgery with resection of the duplication cyst and complete removal of the mucosa containing ectopic gastric tissue while preserving adequate bowel length. A good postoperative outcome with complete symptom resolution was seen in all. Enteric duplication cyst should always be considered in children presenting with occult or overt lower gastrointestinal hemorrhage, and Tc(99m) pertechnetate scan should be done prior to invasive tests like balloon enteroscopy.

Outcome of first‐trimester fetal abdominal cysts: cohort study and review of the literature

The aims of this study were to ascertain the outcome of fetuses with an abdominal cyst detected at 11-14 weeks' gestation in our unit and to undertake a review of cases reported in the literature. This was a retrospective study that included all fetuses found to have an abdominal cyst on ultrasound examination at 11-14 weeks, identified over a 14-year period. Pregnancy management and outcome were ascertained from maternal and neonatal records. We also performed a review of the literature using a systematic search strategy, to identify the outcome of similar cases and propose a management algorithm. Fourteen cases were identified during the study period, of which four had associated abnormalities. Of the 10 isolated cases, the cyst had resolved at follow-up scan in eight (80.0%), one fetus died in utero at 15 weeks' gestation and the other case underwent surgery for a choledochal cyst 9 weeks after birth. An additional 19 cases were reported in the literature. In eight fetuses there were associated structural abnormalities, of which four had a diagnosis of anorectal malformation after birth. In two of these four, the cyst resolved in the second trimester. Of those cases with an isolated cyst (n = 11), the cyst resolved in seven (63.6%). The remainder were variably diagnosed as hepatic cyst, ileal duplication or choledochal cyst. Fetal abdominal cysts at 11-14 weeks' gestation are rare. They constitute an isolated finding in the majority of cases and are usually associated with a good perinatal outcome. In view of the reported association with anorectal and other gastrointestinal malformations, perinatal assessment is recommended, even if the cyst resolves during pregnancy.

Imaging in gastroenterology.

Imaging in gastroenterology.

English

Alimentary tract duplications are uncommon congenital anomalies. A case of male neonate referred with antenatally diagnosed cystic lesions in the thorax and abdomen is presented, which represents a rare example of coexistence of ileal and esophageal duplication cysts with a concurrent Completely Isolated Duplication Cyst (CIDC). Awareness of varied presentations may help in appropriate management during surgery.

Single-Incision Laparoscopic Surgery in Diagnosis and Treatment for Gastrointestinal Bleeding of Obscure Origin in Children

In this multimedia manuscript with video presentation, we reported our experience of performing single-incision laparoscopic surgery (SILS) on 3 children who presented with gastrointestinal bleeding from congenital small bowel lesions. Preoperative investigations including endoscopy and technetium scintigraphy were all negative in the 3 patients aged 4, 7, and 10 years, respectively. SILS was performed using reusable 3- and 5-mm ports and standard straight instruments. The small bowel lesions were located by SILS and the bowel segment with the pathology was exteriorized through the umbilical wound for extracorporeal resection. The diagnoses of the 3 children were Meckel's diverticulum, ileal duplication cyst, and multiple small bowel vascular malformations. All the 3 children recovered uneventfully from surgery without any complications and required minimal postoperative analgesia. Our experience suggested that SILS is an effective alternative to conventional laparoscopy in both diagnostic and therapeutic functions for children with gastrointestinal bleeding of obscure origin.

Giant ileal duplication cyst presenting as malrotation

IntroductionAlimentary Tract Duplications (ATDs) are rare anomalies. The ileum is the most common site. Completely isolated ileal duplication cysts (IDCs) are a small subgroup of IDCs that do not communication with the gastrointestinal tract. These cysts may manifest in a variety of ways. Presentation of caseWe discuss a six-day-old female infant who presented with clinical and radiologic features of malrotation. At the time of laparotomy the bowel rotation was found to be normal, however an isolated IDC was found and resected. DiscussionIleal duplication cysts often present with bowel obstruction. In rare cases these can present with features of malrotation on upper gastrointestinal contrast series, thus detracting from the real pathology. ConclusionWe identify a rare case of completely isolated IDC presenting as malrotation in a six-day-old female infant, which was promptly recognized and surgically managed. We suspect that the weight of the duplication cyst displaced the bowel inferiorly and thus gave the radiographic appearance of malrotated bowel.

Ileal duplication cyst associated with segmental ileal stenosis and neonatal perforation

A prenatally diagnosed terminal ileal duplication cyst associated with prenatal segmental mesenteric vascular thrombosis, ileal stenosis and proximal ileal perforation presenting in the neonatal period with bilious vomiting secondary to obstruction and perforation proximal to the segmental ileal stenosis in the proximal ileum has been reported. Plain X-ray, ultrasound scans and contrast studies were helpful in diagnosis. She underwent exploratory laparotomy, resection of terminal ileal duplication cyst with end-to-end anastomosis, resection of perforated stenotic proximal ileal segment with double barrel ileostomy formation uneventfully. She had staged closure of ileostomy and recovered well.

Importance of the Ultrasonography in Diagnosis of Ileal Duplication Cyst

Gastrointestinal duplication cysts are rare congenital anomalies that can be seen in anywhere of the gastrointestinal system from the mouth to the anus. These are prenatally diagnosed through antenatal ultrasonography. However, attention must be paid since these formations might be confused with ovarian or mesenteric cysts. Our patient, who had been diagnosed with ovarian cyst on the ultrasonography performed in another center and with mesenteric cyst based on the abdominal MRI carried out at fifth month of life, presented to our clinic with the only complaint of constipation at 9th month of life. The diagnosis was set through double wall appearance of duplication cyst on the abdominal ultrasonography. The patient's cyst was resected.

Ileal duplication mimicking intestinal intussusception: A congenital condition rarely reported in adult

Intestinal duplication is an uncommon congenital condition in young adults. A 25-year-old man complained of chronic, intermittent abdominal pain for 3 years following previous appendectomy for the treatment of suspected appendicitis. Abdominal discomfort and pain, suggestive of intestinal obstruction, recurred after operation. A tubular mass was palpable in the right lower quadrant. Computed tomography enterography scan identified suspicious intestinal intussusception, while Tc-99m pertechnetate scintigraphy revealed a cluster of strip-like abnormal radioactivity in the right lower quadrant. On exploratory laparotomy, a tubular-shaped ileal duplication cyst was found arising from the mesenteric margin of the native ileal segment located 15 cm proximal to the ileocecal valve. Ileectomy was performed along with the removal of the duplication disease, and the end-to-end anastomosis was done to restore the gastrointestinal tract continuity. Pathological examination showed ileal duplication with ectopic gastric mucosa. The patient experienced an eventless postoperative recovery and remained asymptomatic within 2 years of postoperative follow-up.

A Peculiar Cause for Metabolic Acidosis in the Newborn

Metabolic acidosis is often encountered in a sick neonate and intestinal duplication with heterotopic gastric mucosa is a well-established condition. We present a previously unreported relationship between neonatal metabolic acidosis, resulting from transperitoneal absorption of hydrochloric acid, and a ruptured non- communicating ileal duplication cyst with gastric mucosal heterotopia. The neonate recovered rapidly after resection of the ileal duplication. We present this case to highlight a rare but surgically correctable cause of neonatal metabolic acidosis.

A Rare Case of Perforated Tubular Ileal Duplication in 72-Year-Old Male

Enteric duplication is a rare anomaly, which is common in pediatric population, and it is very rare in adults. Enteric duplication can occur anywhere from mouth to anus. Ileal duplication is the most common (30%) followed by duodenum, stomach, jejunum, colon and rectum. Though most cases are presented within the first 2years of life, some may present at later age. Here we report a case of a 72-year-old male presented to us in emergency as acute abdomen, which was presumptively diagnosed as ca rectosigmoid, but later the patient developed perforative peritonitis. On exploratory laparotomy he was diagnosed as a case of perforated ileal duplication cyst. Though these lesions are very rare, the importance of enteric duplication cysts lies in the fact that they can mimic many disease conditions and may be left untreated.

Unusual presentation of an ileal duplication cyst

INTRODUCTIONAlimentary tract duplications (ATDs) are rare anomalies. The ileum is the most common site. Completely isolated ileal duplication cysts (IDCs) are a small subgroup of IDCs with their own exclusive blood supply. PRESENTATION OF CASEWe present a six day old female infant who presented with clinical and radiological features of type three malrotation. DISCUSSIONIleal duplication cysts often present with bowel obstruction, but in rare cases can present with features of malrotation on upper gastrointestinal contrast series, thus detracting from the real pathology. CONCLUSIONWe present a rare case of completely isolated IDC presenting as malrotation in a six-day-old female infant which was recognized timely and surgically removed.

Intussusceptions Associated with an Ileal Duplication Cyst

Intussusceptions Associated with an Ileal Duplication Cyst

Unusual Noncommunicating Isolated Enteric Duplication Cyst in Adults

Duplication cysts are rare gastrointestinal congenital abnormalities and can occur anywhere within the gastrointestinal tract. Duplication cysts are firmly attached to or share the wall of the alimentary tract and have a common blood supply with the adjacent segment of the bowel. Completely isolated duplication cysts are an extremely rare variety of gastrointestinal duplications with their own exclusive blood supply, and they do not communicate with the intestine. These cysts are usually diagnosed during early childhood, and very rarely detected in adults, mostly incidentally, due to a lack of symptoms. A 28-year-old male was admitted to our hospital with a chief complaint of lower abdominal pain and distention and a palpable mass for 1 month. Based upon computed tomography and sonographic findings, a small bowel duplication cyst was tentatively diagnosed. The cyst had no connection to the gastrointestinal tract. Herein we report the case of a noncommunicating isolated ileal duplication cyst in an adult. Resection of the cyst was performed safely without requiring bowel resection.

Successful Laparoscopic Treatment of Hemorrhage from Ileal Duplication Cyst in a 10-Year-Old Saudi Boy

Lower gastrointestinal hemorrhage often produces diagnostic difficulty in children. Endoscopy, radionuclide scans, computed tomography/magnetic resonance angiography, and conventional angiography have been the usual armamentarium for locating the site of bleeding. In recent times, laparoscopy has offered an effective tool for diagnosing various intra-abdominal, especially extraluminal, pathologies elusive to other modalities of diagnosis. In this paper, we present a case of massive hemorrhage from an ileal duplication cyst in a 10-year-old Saudi boy diagnosed and treated by laparoscopy. We believe this is the first such reported case from the Kingdom of Saudi Arabia.