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

Ekbote, Gajanan; Pokharkar, Ashish; Moon, Prashant

doi:10.1007/s12262-012-0749-4

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…It can be sited on either the mesenteric or the antimesenteric side of the bowel wall, with a mesenteric preponderance, [ 1 ] and its length ranges from few centimeters to whole length of the small intestine. [ 17 ] Most of the time, it is single, while concurrent multiple cysts are exposed in 10% to 15% of cases. It appears unilocular mostly, but sometimes could be multilocular, or even multilobulated.…”

Section: Discussionmentioning

confidence: 99%

A huge completely isolated duplication cyst complicated by torsion and lined by 3 different mucosal epithelial components in an adult

Jin-Jing²,

Li-Chen³

et al. 2018

Medicine

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Rationale:Intestinal or enteric duplication (ED) does exit as a rare congenital malformation of the gastrointestinal system clinically. It is a separate entity, but can be communicated with the gastrointestinal tract. It is characterized by a well-developed muscular wall and lumen endowed with ectopic mucosa, simulating a portion of normal bowel. A completely isolated duplication cyst (CIDC) refers to an extremely uncommon variant of ED, which is secluded from the alimentary tract and possesses its own exclusive blood supply. Surgical procedure is the treatment of choice, because most often, a definitive diagnosis can only be confirmed intraoperatively.Patient concerns:A 20-year-old male patient presented with a 10-day history of intermittent episodes of abdominal pain. The pain evolved from dull into progressive and intolerable, accompanied by vomiting, nausea, and abdominal distention.Diagnoses:Closed-loop small-bowel obstruction with volvulus.Interventions:The patient underwent an emergency exploratory laparotomy.Outcomes:A huge CIDC was observed upon operation, which was affixed to the mesentery with only a narrow base, just like a pedicle; 720° counterclockwise twisting around its base was definitely noted, provoking the compromised blood supply. Complete excision of the cyst was performed along its base safely without violating the intestinal tract. Furthermore, the ectopic mucosa of the cyst exhibited 3 different epithelial lining components histopathologically.Lessons:Clinicians should be aware of the possibility of the existence of a duplication and raise a high index of suspicion in case of equivocal diagnosis, particularly in adult population. A low threshold for surgical management should be recommended in order to prevent lethal outcomes.

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Section: Discussionmentioning

confidence: 99%

A huge completely isolated duplication cyst complicated by torsion and lined by 3 different mucosal epithelial components in an adult

Jin-Jing²,

Li-Chen³

et al. 2018

Medicine

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“…Duplication cysts are rare congenital malformations (1/10,000 live birth) that can appear anywhere in the gastrointestinal tract from the oral cavity to the anus 2 3 4 . Eighty percent are diagnosed in children below the age of 2 years, with a male predominance 1 2 . The ileum is the most frequently affected site 2 .…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms include abdominal pain, vomiting, melena, constipation, intussusception, and ileus 1 2 3 4 5 6 7 8 . They can be easily misdiagnosed as other disorders, including appendicitis, Crohn’s disease, and Meckel’s diverticulum.…”

Section: Discussionmentioning

confidence: 99%

“…Duplications of the gastrointestinal tract are rare congenital anomalies that are often found early in life (more than 80 % are diagnosed in children under 2 years of age, and rarely in adults) 1 2 . The preoperative diagnosis of duplication cyst is difficult because the clinical manifestations are highly variable, especially in adults.…”

Section: Introductionmentioning

confidence: 99%

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Duplication cyst of the ileum presenting with severe anemia detected by double-balloon endoscopy

et al. 2018

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Background and study aims Duplication cysts of the ileum are rare and present with non-specific clinical manifestations such as abdominal pain, vomiting, melena, and intussusception. Therefore, preoperative diagnosis is difficult. Here, we report a case of duplication cyst of the small intestine that was diagnosed preoperatively using double-balloon enteroscopy. A 19-year-old man presented with severe iron deficiency anemia, abdominal pain, and exertional dyspnea. Gastroscopy and colonoscopy revealed no remarkable findings. Abdominal computed tomography revealed a cystic structure in the ileum. Therefore, we performed double-balloon enteroscopy via the anal route. The intestinal tract was bifurcated, with one segment ending in a blind sac containing normal villi and an ulceration. Tc-99 m pertechnetate scintigraphy showed no accumulation in the lesion. Accordingly, we diagnosed a duplication cyst and suspected that this was the cause of severe anemia. Following small bowel resection with cyst excision and anastomosis, the anemia and presenting symptoms resolved. This report highlights the usefulness of double-balloon enteroscopy of the small intestine for preoperative diagnosis of the obscure gastrointestinal bleeding, including duplication cysts .

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“…Intralesional calcifications, bony destruction of the coccyx and sacrum, and hypoattenuating fat within the lesions are features of teratomas and were not seen in our case. 22,24,27,28,[31][32][33] Developmental cysts are generally benign but do have the potential to undergo premalignant and malignant transformations. The presence of adenocarcinoma within a completely isolated duplication cyst has been reported.…”

Section: Differential Diagnosismentioning

confidence: 99%