Intrathoracic Alimentary Tract Duplication Cysts Treated in utero by Thoracoamniotic Shunting

Martı́nez-Ferro, Marcelo; Milner, Ross; Voto, Liliana S.; Zapaterio, J; Cannizzaro, Claudia; Rodrı́guez, Susana; Bonifacino, G; Sánchez, José María; Adzick, N. Scott

doi:10.1159/000020866

Cited by 27 publications

(2 citation statements)

References 4 publications

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“…11 Es inusual que causen compromiso vital al feto, pero se han descrito casos de fetos hidrópicos por el crecimiento del quiste que han requerido shunt toracoamniótico intraútero. 12 Más del 65% de los casos se diagnostican durante el primer año de vida. 13 Los neonatos suelen estar asintomáticos, pero pueden presentar clínica variada, desde síntomas gastrointestinales inespecíficos (rechazo del alimento o vómitos) hasta síntomas de obstrucción por efecto masa o complicaciones, como torsión o infección.…”

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Duplicación quística intestinal. Caso clínico

et al. 2017

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Presentación de casos clínicos RESUMENLas duplicaciones intestinales quísticas son anomalías congénitas infrecuentes, con incidencia de 1:4500 autopsias y etiopatogenia incierta. Son estructuras quísticas, tubulares o diverticulares revestidas de mucosa gastrointestinal con pared de músculo liso, adheridas al tracto gastrointestinal, pero no suelen comunicar con la luz intestinal. Los quistes de duplicación gástrica representan el 7-9% de los quistes de duplicación intestinal. Pueden diagnosticarse intraútero mediante ecografía y la resonancia magnética fetal permite caracterizar el quiste y descartar patologías concomitantes. La ecografía posnatal revela una imagen quística de "doble pared". Los neonatos suelen permanecer asintomáticos, pero pueden presentar desde síntomas gastrointestinales inespecíficos hasta síntomas de obstrucción por efecto masa, torsión o infección. En pacientes asintomáticos, se aconseja el seguimiento clínico y estudios de imagen periódicos. El tratamiento es la resección quirúrgica electiva, de manera preferente, con técnicas mínimamente invasivas. Se presenta un caso con sospecha prenatal de quiste de duplicación enteral. Palabras clave: recién nacido, anomalías congénitas, anomalías del sistema digestivo, quistes, ultrasonografía fetal. ABSTRACTIntestinal cystic duplications are rare congenital anomalies, with an estimated incidence of approximately 1:4500 autopsies. The etiopathogenesis is uncertain. These duplications are cystic, tubular or diverticular structures lined with gastrointestinal mucosa. They share a common smooth muscle wall with the gastrointestinal tract but usually their lumens do not communicate with each other. Gastric duplication cysts represent 7-9% of the gastrointestinal tract duplication. They can be diagnosed prenatally by fetal ultrasound; magnetic resonance imaging characterizes the cyst and excludes other malformations. Postnatal ultrasound shows a characteristic double walled cyst. Newborns are usually asymptomatic, although nonspecific gastrointestinal symptoms, intestinal obstruction due to mass effect, volvulus or infection are described. In asymptomatic patients, clinical follow-up and Duplicación quística intestinal. Caso clínicoIntestinal cystic duplication. Case report periodic image controls are recommended. Elective surgical resection is the treatment of choice, using minimally invasive technique whenever possible. A case of prenatally suspected intestinal cystic duplication is presented.

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Section: Discussionunclassified

Duplicación quística intestinal. Caso clínico

et al. 2017

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“…However, the double wall sign can also be a characteristic of Meckel's diverticulum or sonographic artifacts. Furthermore, Meckel's diverticulum can have a spherically shaped cystlike appearance, which is similar to an enteric duplication cyst, on sonography [ 7 – 9 ]. Although Meckel's diverticulum is located on the antimesenteric border and communicates with the adjacent bowel lumen, in contrast to the duplication cyst, these differentiating features are often not visible on USG or CT [ 10 , 11 ].…”

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Importance of the Ultrasonography in Diagnosis of Ileal Duplication Cyst

Gebeşçe

Korkmaz

Keleş

et al. 2013

Gastroenterology Research and Practice

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Gastrointestinal duplication cysts are rare congenital anomalies that can be seen in anywhere of the gastrointestinal system from the mouth to the anus. These are prenatally diagnosed through antenatal ultrasonography. However, attention must be paid since these formations might be confused with ovarian or mesenteric cysts. Our patient, who had been diagnosed with ovarian cyst on the ultrasonography performed in another center and with mesenteric cyst based on the abdominal MRI carried out at fifth month of life, presented to our clinic with the only complaint of constipation at 9th month of life. The diagnosis was set through double wall appearance of duplication cyst on the abdominal ultrasonography. The patient's cyst was resected.

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Prenatal sonographic features of esophageal and ileal duplications at 18 weeks of gestation

et al. 2004

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We present a case of esophageal and ileal duplications at 18 weeks of gestation. Transabdominal ultrasonography of the fetus showed multiple cystic masses of 12 to 17 mm in diameter and continuity with each other in the abdomen and a unilocular cystic mass of 15 mm in diameter in the posterior mediastinum. The cystic mass filled the abdominal cavity with signs of intestinal obstruction. The thoracic cystic mass was tubular, sausage-shaped and behind the heart, which was displaced to the antero-lateral wall of the chest. Amniocentesis revealed a normal fetal karyotype 46,XY. Peristaltic movements in the abdominal cystic structure at 30 weeks of gestation suggested dilated intestinal loops. Follow-up ultrasound examinations showed polyhydramnios with amniotic fluid index of 30 cm and gradual enlargement of the cystic structures to 50 mm in the abdomen and 30 mm in the posterior mediastinum at 38 weeks of gestation. A male infant weighing 3900 g was delivered. Postnatal ultrasonographic examination and the findings of magnetic resonance imaging also suggested enteric duplication cysts. Prenatal diagnosis allowed prompt neonatal evaluation and surgical treatment of the esophageal and the ileal duplications, which was confirmed by pathological examination.

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Intrathoracic Alimentary Tract Duplication Cysts Treated in utero by Thoracoamniotic Shunting

Cited by 27 publications

References 4 publications

Duplicación quística intestinal. Caso clínico

Duplicación quística intestinal. Caso clínico

Importance of the Ultrasonography in Diagnosis of Ileal Duplication Cyst

Prenatal sonographic features of esophageal and ileal duplications at 18 weeks of gestation

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