Gastrointestinal Duplication Presenting as Neonatal Intestinal Obstruction: An Experience of 15 Years at Tertiary Care Centre

Abstract

Background: Gastrointestinal tract (GIT) duplications are one of the rare congenital anomalies and can occur in any portion of the gastrointestinal tract but are more commonly encountered in small intestine. The duplication cysts cause symptoms like abdominal mass and intestinal obstruction requiring surgery or may remain asymptomatic. We are reporting our 15 years' experience duplication cysts presenting in neonates.

Duplicaciones del tracto gastrointestinal en niños, presentación de dos casos. Hospital Infantil Doctor Robert Reid Cabral (HIRRC), República Dominicana

“…El tipo de célula que más comúnmente reviste esta condición es mucosa gástrica, responsable del 50 % de los casos seguido de mucosa intestinal, pancreática o epitelio respiratorio. 3,9,10 La mucosa gástrica heterotópica puede causar sangrado o perforación por ulceración péptica. Esta condición puede estar asociada a otras anomalías como duplicación colónica completa, divertículo gástrico y quistes neuroentéricos.…”

“…Se han encontrado varias anomalías congénitas asociadas a la DTG, en particular malformaciones vertebrales y genitourinarias. 9,10,11 Los métodos diagnósticos comunes incluyen ultrasonografía (USG), tomografía computarizada (TC), imagen de resonancia magnética (IRM), gammagrafía y serie gastrointestinal alta. Se han reportado varios casos prenatales por USG e IRM.…”

In utero ileal volvulus and intestinal perforation associated with enteric duplication cyst presenting with preterm labour and acute abdomen in newborn

“…There are only a few case series and reports of neonatal bowel obstruction caused by enteric duplication cysts—none of which describe an in utero process of bowel ischaemia and perforation precipitating preterm delivery 4 5 7 9–11. The majority of neonatal bowel obstructions manifest after birth and are often attributable to intestinal atresia, malrotation or meconium disease.…”

“…The most common location of enteric duplication cysts is the ileum (40% of cases) 1–4. First reported by Fitz in 18845 and subsequently described by Ladd in 1937 as a phenomenon of ‘alimentary tract duplications’,6 80% of enteric duplication cysts present in the first 2 years of life 2 7. Duplication cysts are hollow, epithelium-lined, cystic (90%) or tubular (10%) structures surrounded by a smooth muscle layer occurring anywhere along the alimentary tract from the mouth to the anus, often sharing a common blood supply with the adjacent bowel.…”

Caecal duplication cyst: a rare cause of neonatal intestinal obstruction

“…The most common imaging modalities to diagnose duplication cysts are ultrasonography and Barium studies, whereas CT and MRI are less often used 8. Lower abdominal cystic lesions on ultrasound in case of neonatal intestinal obstruction may discuss the diagnosis of alimentary tract duplication, mesenteric cyst, meconium pseudocyst and ovarian compressive cyst.…”