Complete foregut duplication

A sudden hemorrhage in the esophageal duplication cyst: A rare cause of acute dysphagia in an adult

A 42-year-old male pediatrics physician was admitted with a history of acute chest pain and sudden severe dysphagia to solids and liquids. He denied any history of abdominal pain, vomiting, dyspnea, nausea weight loss. He could not even swallow saliva. The patient denied any history of drug abuse. A computed tomographic scan of the chest (CT)showed a posterior mediastinal mass inseparable from the esophagus and descending aorta. Magnetic resonant imaging (MRI)scan revealed a cystic mass full of blood inseparable from the esophagus and adherent to the aorta. The mass was resected entirely through the left thoracotomy; post-operative recovery was uneventful; dysphagia resolved as the post-operative contrast swallow study showed a free flow of contrast to the stomach patient resumed his regular diet.

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A 42 years old male presented with chest discomfort and acute dysphagia.

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CT scan and MRI showed hemorrhagic large posterior mediastinal cystic mass compressing the esophagus.

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Oral contrast study showed obstruction of lower esophagus.

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Complete surgical excision was done with uneventful outcome.

Tubular duplication of the oesophagus presenting with dysphagia

Duplications of the alimentary tract are rare congenital malformations, with the ileum being the most commonly affected site, followed by the oesophagus. Among oesophageal duplications, cystic duplication is the most common and the tubular variety, the rarest. Herein, we report a rare case of tubular oesophageal duplication, complicated by adenosquamous carcinoma at the lower end of the oesophagus, in a 32-year-old man who presented with progressive dysphagia. Although proton pump inhibitors may relieve dysphagia, oesophagectomy and gastric interpositioning should be the first-line treatment for patients with tubular oesophageal duplication, in order to reduce the risk of malignant transformation at the lower end of the oesophagus.

Foregut duplication cyst: an unusual presentation during childhood

Congenital duplications can occur anywhere in the GIT, one third of all duplications are foregut duplications (esophagus, stomach, first and second part of duodenum). Respiratory symptoms are the most common symptoms in foregut duplications, most cases present with respiratory distress which may be present from birth, or symptoms may be insidious with cough, wheeze, or recurrent respiratory infections. We are presenting a 2-year-old boy presenting with cough and fever. Radiological investigation showed left mediastinal mass that was removed by excisional biopsy and revealed an esophageal cyst. Cough with or without fever could be rare presentations for esophageal cyst.

Gastrointestinal images: complete tubular duplication of the oesophagus in an adult

INTRODUCTION

Duplication of the oesophagus is a rare congenital abnormality that usually presents in children. Presentation in adults is extremely rare.

CASE HISTORY

We report a case of a19-year-old gentleman presenting with general gastrointestinal symptoms of pain and dysphagia. Diagnosis was made with CT and contrast studies, demonstrating complete tubular duplication of the oesophagus with communications at both ends of the duplication. The patient was managed conservatively.

DISCUSSION

We describe the difficulty in diagnosing these rare congenital abnormalities. We recommend that with a multi-disciplinary approach, conservative management can be considered.

Congenital diaphragmatic hernia associated with a gastroesophageal duplication cyst: a case report

Severe left congenital diaphragmatic hernia was diagnosed in a baby prenatally, and she underwent hernia repair on the sixth postnatal day of life. She was found to have a huge symptomatic gastroesophageal duplication cyst on day 24 of life. A thoracoabdominal dissection allowed successful cyst excision. J Pediatr Surg 36:626-628.

Continuous communicating esophageal and gastric duplication

Duplications of the esophagus or stomach alone are infrequent, and complete foregut duplication has only rarely been described. Most combined esophagogastric duplications present within the first year of life, and if communication with the normal alimentary tract does occur, it does so only either above or below the diaphragm. This report illustrates a case of continuous duplication of the esophagus and stomach with communication to the normal alimentary tract at both proximal and distal ends. Operative management and a review of the literature and embryology are described.

Tubular communicating duplications of esophagus and stomach

A child with vertebral anomalies and tubular communicating duplications of the esophagus and stomach had a post-natal ultrasound interpreted as normal. This complex anomaly was delineated by barium studies and surgically confirmed.