A rare presentation of colonic duplication cyst: report of a case and review of the literature.

Abstract

Duplication cyst is an extremely rare congenital malformation of the alimentary tract. It occurs most often in the ileum, accounting for over 60% of cases followed by the jejunum and the duodenum (1). The colon is the least common site of enteric duplication. In fact, in a review of 495 alimentary tract duplications only 7% of the duplications involved the colon (2). To our knowledge less than 100 cases have been described in the published literature (3). Case reportWe present an unusual case of colonic duplication cyst in a 45-yearold Caucasian man who presented to our hospital with lumbar pain. The patient had a medical history of constipation. On admission, the patient was afebrile. Physical examination revealed a large mass in the left upper quadrant with mild diffuse tenderness and no peritoneal signs. Blood laboratory tests were within normal limits. An initial plain X-ray was performed with no abnormal findings. Ultrasonography was insignificant due to gas filled bowels. After the first inconclusive radiological exams, a contrast Barium Enema study was decided to be performed. Barium Enema showed a large air-filled tubular structure in the left upper quadrant containing an air-fluid level (Fig. 1). The same cystic structure was partially filled with contrast due to communication with the transverse colon at the splenic flexure. The shape of the cystic structure changed with peristalsis and the position of the patient oral contrast material was performed. It demonstrated a large airfilled 14 × 7 cm structure containing oral contrast in the left upper quadrant (Fig. 3). CT confirmed the findings of contrast Barium Enema study and a possible diagnosis of colonic duplication of the transverse common was concluded. A surgical intervention was decided in order to prevent complications of the colonic duplication cyst. At operation, the cyst was excised with a segment of (Fig. 2). At the same examination the gastric antrum was recognized as a smaller air-filled structure adjacent to the same tubular structure.

Y Shaped Colonic Duplication Mimicking Intestinal Volvulus: A Case Report and Review of Literature

“…Structurally, they can be cystic in 80% and tubular in 20% of cases. Cystic duplications are not related to adjacent intestinal lumen whereas tubular lesions may be related to adjacent colonic lumen adjacent as in our case (17) . It has been reported that ectopic tissue is present in 25-30% of duplicated specimens and most common types of ectopic tissues are gastric followed by pancreatic tissue (6) .…”

Undetected Duplication Cyst of The Cecum Until Adulthood

“…The radiologic examination of our case clearly showed the cystic structure of the mass in addition to the histopathological examination revealing that the cyst lumen was covered with the intestinal mucosa and that it was incorporated with the adjacent intestinal smooth muscle structure. Duplication cysts are typically not related to the adjacent intestinal lumen as observed in our case, whereas tubular lesions may be related to the colon [6].…”

Duplication of the transverse colon in adults: a case report and literature review

“…There is a lack of unified diagnostic and treatment criteria for transverse colonic repetitive malformations. 12 cases were diagnosed using abdominal multirow CT ( 12 , 13 , 15 – 18 , 20 – 24 , 26 ), 8 cases using digitized barium enema colography ( 13 , 14 , 17 – 19 , 22 , 23 , 25 ), and colonoscopy in 4 cases ( 19 , 20 , 25 , 26 ), 8 cases using US ( 13 – 16 , 18 , 20 – 22 ) and 2 cases using plain X-ray ( 16 , 18 ). Because the symptoms of repeat transverse colon malformations in adults are mostly nonspecific, clinical diagnosis is difficult.…”