Sonographic findings in a duodenal duplication cyst

Abstract

We report the sonographic features of a duodenal duplication cyst containing ectopic pancreatic tissue in a 5-month-old boy who presented with symptoms of partial gastric outlet obstruction. Sonography revealed an anechoic, double-walled, bilobed cystic lesion containing debris in the pyloroduodenal region. There was sound through-transmission but no air or communication with the gastrointestinal tract. Surgical resection and histopathologic examination confirmed a duodenal duplication cyst containing pancreatic tissue.

Meta-analysis: the clinical features of the duodenal duplication cyst

“…Clinical presentations are usually nonspecific, such as abdominal pain, with associated weight loss; nausea; vomiting; or specific, recurrent, or chronic pancreatitis [3,8,25]. In this review, the most common symptoms were abdominal pain and nausea/vomiting, manifesting in 80% and 42% of cases, respectively.…”

“…All cysts that present with gastrointestinal bleeding or infection communicate with the native duodenum. When a duplication cyst contains ectopic gastric mucosa, the secretion of peptic acid may cause ulceration and lead to bleeding, which may be occult or massive [5,25]. Besides, some authors have attributed malignant degeneration to the presence of ectopic gastric tissue inside the cyst [14].…”

“…They may be lined with duodenal mucosa, ectopic gastric mucosa, pancreatic, or respiratory epithelium [22,25]. Grossly, most duodenal duplications are cystic and usually communicate with the pancreatic or biliary ducts.…”

Duodenal duplication cyst: beware of the lesser sac collection

“…Ultrasonography may suggest the diagnosis [18]. A higher diagnostic yield is obtained by barium swallow [19].…”

Duodenal duplication cyst communicating with an aberrant pancreatic duct

“…Ultrasonography reveals an anechoic, double-walled, bilobed cystic lesion containing debris in the pyloroduodenal region [8]. CT scanning provides better delineation of the anatomy in relation to the pancreaticobiliary system [2].…”