Infected duodenal duplication with unusual clinical and radiological manifestations: a case report

Abstract

Infected cystic duplication of the duodenum is an unusual lesion. We report a case in which pre-operative MR imaging revealed a huge multicystic mass masquerading as a cystic lymphangioma or mesenteric cyst. The differential diagnosis of this unusual appearance is discussed.

Abscess formation of a spherical-shape duplication in the splenic flexure of the colon: case report and review of the literature

“…Clinical manifestations are dependent primarily on location, shape, size, communication with the gastrointestinal tract, and the presence of heterotopic mucosa. Symptoms are produced when compression, intussusception or volvulus of the attached bowel causes intestinal obstruction [1]. The spectrum of symptoms includes intermittent vomiting, abdominal pain (50%), abdominal distension (30%), palpable mass (20%), peritoneal signs (13%), constipation (6%), bleeding (6%) and perforation, but there is no common clinical pattern of signs for identifying GTDs [5,8,13].…”

“…Ultrasonography is the imaging modality of choice for the detection and diagnosis of duplication cysts, as it will identify a three-layered image, unless complications such as haemorrhage and infection have supervened [1,9]. Approximately 30 to 50% of the intestinal duplications are diagnosed antenatally and the number is gradually increasing [2-4].…”

“…The epithelial lining of the duplication resembles a part of the gastrointestinal or respiratory tract [1]. They are rare congenital malformations with various, potentially dangerous manifestations and are classified according to their location, shape and the presence of ectopic tissue within these.…”

Successful Resection of an Infected Duodenal Duplication Cyst After Percutaneous Cyst Drainage: Report of a Case

“…1 This procedure may not always be possible because of the close relationship of the cyst to the pancreatic ductal or the biliary system, 6,11,16 and when a duplication cyst is accompanied by complications, it is difficult to use conventional procedures. 9 It should be noted that potential chemical peritonitis may be induced by leakage of the cyst contents after external drainage, but if the compromised condition of the patient seems to contraindicate primary excision, performing percutaneous external drainage to manage the patient until their clinical status improves would be a wise alternative.…”

“…9 This patient was diagnosed as having a duodenal duplication cyst with methicillin-resistant Staphylococcus aureus infection. Delayed complete excision of the cyst was then successfully performed after external drainage of the cyst by an open laparotomy, but the cause of the infection was not specified.…”