Rare presentation of pancreatitis secondary to intussusception of duodenal duplication cyst, a pediatric case report

Abstract

a b s t r a c tDuodenal duplication cysts are rare congenital malformations of which there is limited literature in the pediatric population. The most common presentation in symptomatic patients is abdominal pain and pancreatitis. We present a case of a 14 year old female that presented with emesis, abdominal pain, weight loss, and admission biochemical profile concerning for acute pancreatitis in conjunction with severe hypochloremic, hypokalemic metabolic alkalosis. Further imaging was highly suggestive of duodeno-duodenal intussusception causing obstruction of the pancreatic duct. Patient was taken emergently to the operating room for exploration. Patient underwent laparoscopic assisted reduction of intussusception and resection of duodenal duplication cyst. Patient tolerated the surgery well, and was able to be discharged home in stable condition soon after. There have been no cases reported in the literature that describe pancreatitis secondary to intussusception of duodenal duplication cyst. When diagnosed early, these patients can be safely managed laparoscopically even in emergent settings.Ó 2014 The Authors. Published by Elsevier Inc. All rights reserved.Duodenal duplication cysts are rare congenital malformations of the intestinal tract, for which there is limited literature in the pediatric population. The most common presentations of symptomatic cysts include abdominal pain and pancreatitis [1]. We present the first case of pancreatitis secondary to intussusception of duodenal duplication cyst in the pediatric population, requiring emergent surgical intervention.

Taking the Lead: A Case Report of a Leiomyoma Causing Duodeno-Duodenal Intussusception and Review of Literature

“…Abdominal pain and distention, vomiting Tubulovillous adenoma Shakhnovich et al 16 14 Vomiting Duplication cyst Gardner-Thorpe et al 5 66…”

“…4 Intussusception of the proximal small bowel, especially with the intussusceptum and intussuscipiens isolated to the duodenum, is a rare condition with only 16 reported cases in the literature occurring in 19 total patients (Table 1). 1,2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17] Typically, the anatomic position of the duodenum in the retroperitoneal space and its fixed attachments in this region serve to prevent it from being susceptible to intussusception. However, this condition can occur due to a lead point such as a mass (90% of adults cases) 18 or secondary to congenital malrotation of the bowel, where the duodenum is more mobile, allowing the intussuception to occur.…”

Gangliocytic paraganglioma leading to duodeno-jejunal intussusception: A case report

“…Differential diagnosis covers lipoma, fibrolipoma, GIST, hamartoma, Brunner's gland adenoma, leyomioma, adenoma, villous and tubulovillous adenoma, duodenal membrane, duplication cyst, adenocarcinoma, duodenal ulcera, and pancreatic head cancer [2 , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] .…”