Incidentally discovered enteric duplication cyst: a case report
DOI:
https://doi.org/10.6092/1828-6550/APMB.106.1.2018.A5Keywords:
enteric duplication, ileocecal resection, ileocecal valve/junction, abdominal massAbstract
Enteric duplications are rare congenital diseases with heterogeneous clinical pictures ranging from an asymptomatic course to life-threatening consequences, most commonly arising at the ileal and ileocecal region. The antenatal discovery is possible when it concerns a voluminous cystic form enabling an early management. The radiologic examinations are nonspecific and no diagnostic tools can allow a certain diagnosis on its own. Sometimes, the diagnosis of intestinal duplication is only made during the surgical exploration and confirmed after a histopathological examination.
We report a 4 years old girl with antenatal diagnosed ovarian cystic mass of about 4 mm. She was admitted to our unit for abdominal pain and constipation. Abdominal ultrasonography showed a cystic mass in the right iliac fossa. MRI revealed a well-defined cystic mass (6 x 4.2 x 5.4 cm) in the right mid abdomen displacing the bowel to the left, likely to be strongly adherent to the last part of the ileum. 99mtc pertechnetate scan was negative for ectopic gastric mucosa. A laparoscopic approach was eventually necessary and the diagnosis of duplication cyst was confirmed.
Children with antenatal diagnosis of abdominal mass need a close follow up and enteric duplication should be considered as potential diagnosis. The laparoscopic approach has an important role in differential diagnosis between intestinal duplications and other mass.
References
1. Okur, M.H., Arslan, M.S., Arslan, S., Aydogdu, B., Turkcu, G., Goya, C., Uygun, I., Cigdem, M.K., Önen, A., Otcu S. (2014). Gastrointestinal tract duplications in children. Eur Rev Med Pharmacol Sciences; 18: 1507-1512. PMID:24899610
2. Rattan, K.N., Bansal, S., Dhamija, A. (2017). Gatrointestinal Duplication Presenting Neonatal Intestinal Obstruction : an experience of 15 years at tertiary care centre. J Neonat Surg.; 6:5,. DOI: 10.21699/jns.v5i4.432.
3. Spinelli, C . (2001). Chirurgia Neonatale Delle Malformazioni Dell’intestino Primitivo Di Maggiore Incidenza. PICCIN, Padova;
4. Gross, R.E., Holcomb, G.W., Farber,S. (1952). Duplication of the alimentary tract. Pediatrics; 9:449–468 doi: 10.1007/s40477-015-0188-8
5. Fitz, R.H. (1884). Persistent omphalomesenteric remains: their importance in the causation of intestinal duplication, cyst formation and obstruction. Am J Med Sci.;88:30-57.
6. Gross, R.E. (1953). Duplications of the alimentary tract. The Surgery of Infancy and Childhood.:221-45
7 .Bremer, J.L. (1944). Diverticula and duplications of the intestinal tract. Arch Pathol.; 38:132–140.
8. Lister, J. (1990). Duplications of the alimentary tract. In: Lister J, Irwing M, editors. Neonatal Surgery, England, Butterworths.:p474-84.
9. Master, V.V., Woods, R.H., Morris, L.L., Freeman, J. (2004). Gastric duplication cyst causing gastric outlet obstruction. Pediatr Radiol.;34:574–6.
10. Al-Zaiem, M.M. (2011). Assisted laparoscopic excision of huge abdominal cysts in newborns and infants using the umbilical laparoscopic port incision. J Pediatr Surg;46: 1459-63. DOI: 10.1016/j.jpedsurg.2011.03.004.
11. Di Serafino. M., Mercogliano, C., Vallone, G. (2016). Ultrasound evaluation of the enteric duplication cyst: the gut signature, J Ultrasound. Jun; 19(2): 131–133. DOI: 10.1007/s40477-015-0188-8
12. Parker, B.C., Guthrie, J., France, N.E., Atwell, J.D. (1972). Gastric duplications in infancy. J Pediatr Surg.;7:294–298. DOI: https://doi.org/10.1016/0022-3468(72)90128-5
13. Puligandla, P.S., Nguyen, L.T., St-Vil, D., Flageole, H., Bensoussan, A.L., Nguyen, V.H., Laberge, JM. (2003). Gastrointestinal duplications. J Pediatr Surg.;38:740–744. DOI: https://doi.org/10.1016/jpsu.2003.50197
14. Ildstad, S.T., Tollerud, D.J., Weiss, R.G. et al. (1988). Duplications of the alimentary tract. Clinical characteristics, preferred treatment, and associated malformations. Ann Surg.;208:184–189.Crossref
15. Berseth C.L. (1998). Avery’s Diseases of the Newborn. 7th ed. WB Saunders Company;. Disorders of the intestine and Pancreas. In: Taeusch HW, Ballard RA editors; p. 923.
16. Cavar,S., Bogovic, M., Leutic, T., Antabak, A., Batinica, S. (2006). Intestinal duplications – experience in 6 cases. Eur Surg Res.;38:329–32. DOI:10.1159/000094021
17. Di Serafino, M., Mercogliano, C., Vallone G. (2015) Ultrasound evaluation of the enteric duplication cyst: the gut signature. J Ultrasound. Nov 23;19(2):131-3. doi: 10.1007/s40477-015-0188-8. eCollection 2016 Jun..
18. Lee, N.K., Kim, S., Jeon, T.Y., Kim, H.S., Kim, D.H., Seo, H.I., Park, D.Y., Jang, H.J. (2010). Complications of congenital and developmental abnormalities of the gastrointestinal tract in adolescents and adults: evaluation with multimodality imaging. Radiographics.;30:1489-507. DOI: 10.1148/rg.306105504,
19. Fanaroff, A.A. (2001) . Care of the High Risk Neonate. 5th ed. Harcourt (India) Pvt Ltd, WB Saunders; 2001. Selected Disorders of the Gastrointestinal Tract. In: Klaus MH, Fanaroff AA, editor; p. 179.
20. Esposito, C., Alicchio, F., Savanelli, A., Ascione, G., Settimi, A. (2009). One-trocar ileo-colic resection in a newborn infant with a cystic lymphangioma of the small-bowel mesentery. J Laparoendosc Adv Surg Tech A;19:447-9. DOI: 10.1089/lap.2008.0261.
21. Merrot, T., Anastasescu, R., Pankevych, T., Tercier, S., Garcia S., Alessandrini, P., Guys, J.M. (2006) Duodenal duplications. Clinical characteristics, embryological hypotheses, histological findings, treatment. Eur J Pediatr Surg.;16:18–23. DOI: 10.1055/s-2006-923798
22. Holcomb, G.W., Gheissari, A., O’Neill, J.A., Shorter, N.A., Bishop, H.C. (1989). Surgical management of alimentary tract duplications. Ann Surg; 209: 167-174
23. Iyer, C.P., Mahour, G.H. (1995). Duplications of the alimentary tract in infants and children. J Pediatr Surg.;30:1267–1270. PMID: 8523222
24. Adair, H.M., Trowell, J.E. (1981). Squamous cell carcinoma arising in a duplication of the small bowel. J Pathol;133(1):25-31. DOI: 10.1002/path.1711330104
25. Ma, H., Xiao, W., Li, J., Li, Y.(2012). Clinical and pathological analysis of malignancies arising from alimentary tract duplications. Surgical Oncology 21; 324-330. DOI: https://doi.org/10.1016/j.suronc.2012.09.001" target="_blank">https://doi.org/10.1016/j.suronc.2012.09.001
26. Blank, G., Königsrainer, A., Sipos, B., Ladurner, R. (2012). Adenocarcinoma arising in a cystic duplication of the small bowel: case report and review of literature,. World Journal of Surgical Oncology, 10:55. DOI: 10.1186/1477-7819-10-55
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
