Cysts of Gastrointestinal Origin in Children: Varied Presentation

Tiwari, Charu; Shah, Hemanshi; Waghmare, Mukta; Makhija, Deepa; Khedkar, Kiran

doi:10.5223/pghn.2017.20.2.94

Cited by 35 publications

(20 citation statements)

References 22 publications

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“…[ 18 ] Frequently, a duplication is mobile, and can be observed as a palpable mass in 50% of cases. [ 19 ] Rarely can an ED have its own autonomous blood supply independent from the neighbouring bowel tract; conversely, it shares the common vessel system with the mesentery. [ 20 ] Even some additional associated anomalies have been encountered in 50% of patients, the majority being vertebral defects.…”

Section: Discussionmentioning

confidence: 99%

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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%

“…Regarding its symptoms it is particularly difficult to distinguish an ED from other intra-abdominal cystic etiologies. [ 8 , 19 ] Besides, it is quite confused with a Meckel's diverticulum when locating on the antimesenteric side. Its manifestations may be vague, and lack of specificity, mimicking other diseases.…”

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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“…Their usual complications are infection, perforation, intestinal obstruction, intussusception, or volvulus. 1) However, intestinal duplication has not been previously described in association with the development of PRES.…”

Section: Discussionmentioning

confidence: 99%

Intestinal duplication revealed by posterior reversible encephalopathy syndrome

2018

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We report a unique case of intestinal duplication detected on posterior reversible encephalopathy syndrome (PRES) in a 13-year-old girl. She was admitted to the pediatric Emergency Department because of generalized seizures. Radiological assessment revealed a large, well-defined, thick-walled cystic lesion in the mid abdomen, suggestive of duplication cyst associated to a PRES. Exploration confirmed the diagnosis of ileal duplication cyst, and the mass was resected. The postoperative course was uneventful. Both hypertension and neurological dysfunction resolved after the mass resection. A followup brain magnetic resonance imaging was performed 9 months later and showed complete resolution of the cerebellar changes. Although extrinsic compression of the retroperitoneal structures has not been reported in the literature as a complication of duplication cyst, we strongly believe that this is the most logical and plausible hypothesis that would explain the pathogenesis of PRES in our patient.

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“…The incidence is 1:4,500 births, found in 0.2% of all children, with a slight male predominance [ 3 , 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Enteric duplication cysts in children: varied presentations, varied imaging findings

et al. 2018

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Enteric duplication cysts (EDCs) are rare congenital malformations formed during the embryonic development of the digestive tract. They are usually detected prenatally or in the first years of life. The size, location, type, mucosal pattern and presence of complications produce a varied clinical presentation and different imaging findings. Ultrasonography (US) is the most used imaging method for diagnosis. Magnetic resonance (MR) and computed tomography (CT) are less frequently used, but can be helpful in cases of difficult surgical approach. Conservative surgery is the treatment of choice. Pathology confirms the intestinal origin of the cyst, showing a layer of smooth muscle in the wall and an epithelial lining inside, resembling some part of the gastrointestinal tract (GT). We review the different forms of presentation of the EDCs, showing both the typical and atypical imaging findings with the different imaging techniques. We correlate the imaging findings with the surgical results and the final pathological features.Teaching Points• EDCs are rare congenital anomalies from the digestive tract with uncertain pathogenesis.• More frequently, diagnosis is antenatal, with most EDCs occurring in the distal ileum.• Ultrasonography is the method of choice for diagnosis of EDCs.• Complicated EDCs can show atypical imaging findings.• Surgery is necessary to avoid complications.

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Cysts of Gastrointestinal Origin in Children: Varied Presentation

Cited by 35 publications

References 22 publications

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

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

Intestinal duplication revealed by posterior reversible encephalopathy syndrome

Enteric duplication cysts in children: varied presentations, varied imaging findings

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