Duodenal duplication cyst masquerading as a pancreatic abscess in a cat

Abstract

This report details a cat with a duodenal duplication cyst in the region of the right distal pancreas. The cat presented with vomiting, anorexia, pancreatitis and a palpable abdominal mass that was visible on abdominal ultrasound as a thick-rimmed, cavitated structure with echogenic contents. As such, an initial clinical diagnosis of pancreatic abscess or cyst was suspected. After an exploratory coeliotomy to assess the lesion, a definitive diagnosis of duodenal duplication cyst was determined based on the histopathological findings of a wall with features of the intestinal tract and no communication with the intestinal lumen. The clinical signs, physical examination findings and advanced imaging characteristics of pancreatic abscess and duodenal duplication cyst are discussed in this report to aid clinicians with differentiating between these two rare lesions.

Case report: Surgical management of ileal duplication cyst in a cat: a case report and review of the literature

“…Eight previously reported cases have described enteric duplication cysts associated with the small intestine in cats ( Table 1 ). Of the eight cases, five cases of enteric duplication cysts occurred in the duodenum ( 2 , 3 , 5 , 15 , 16 ), two occurred in the jejunum ( 3 , 15 ), and one occurred in the esophagus and duodenum ( 16 ). To our best knowledge, this is the first reported case of an enteric duplication cyst in the ileum.…”

“…The clinical signs may differ depending on the location and size of the enteric duplication cyst ( 3 , 19 ). Of the eight previously reported cases, five were symptomatic, and the most common clinical sign was vomiting ( 3 , 5 , 16 – 18 ). These are assumed to result from a partial or complete intestinal obstruction ( 22 ).…”

“…According to the veterinary literature, the location of the mass can affect the extent of surgical excision of the mass. In 5/8 previously reported cases of enteric duplication cysts associated with the small intestine in feline patients, surgical management involved subtotal resection with preservation of the adjacent small intestine ( 2 , 3 , 16 , 19 , 21 ). Considering that the mass was located in the duodenum in all five cases, it is assumed that subtotal resection of the mass was performed to preserve the bile and pancreatic ducts.…”

“…Enteric duplication cysts are uncommon congenital anomalies (1) that can occur at any level of the alimentary tract, from the tongue to the anus (2)(3)(4). They are lined with smooth muscle and mucosal layers, similar to other parts of the alimentary tract (3,5,6).…”

“…Enteric duplication cysts are uncommon congenital anomalies (1) that can occur at any level of the alimentary tract, from the tongue to the anus (2)(3)(4). They are lined with smooth muscle and mucosal layers, similar to other parts of the alimentary tract (3,5,6). According to the human literature, their occurrence is rare but are considered as differential diagnoses for upper intestinal obstruction, especially in infants (2,(7)(8)(9).…”