1
|
Alshiekh A, Alkurdi MF, Hadakie R, Alarsan M, Sukkar L, Hamed H. Effective surgical management of gastric outlet obstruction symptoms caused by annular pancreas in an adult female: A case report. Int J Surg Case Rep 2024; 122:110077. [PMID: 39059237 PMCID: PMC11327469 DOI: 10.1016/j.ijscr.2024.110077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/16/2024] [Accepted: 07/22/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION Annular pancreas (AP) is a rare condition that usually is not associated with symptoms in adults. However, in some patients, AP may cause non-specific symptoms such as abdominal pain and vomiting, making its diagnosis challenging. The current case report presents a challenging diagnosis of an AP case and surgical management of it by performing duodenoduodenostomy. CASE PRESENTATION A 47-year-old female presented with chronic abdominal pain and vomiting after meals. The examination using CT showed a complete ring of pancreatic tissue encircling the descending part of the duodenum, confirming the diagnosis of AP. Therefore, the patient underwent duodenoduodenostomy, in which the obstruction was bypassed. CLINICAL DISCUSSION AP is a rare condition characterized by a band of pancreatic tissue that encircles the second part of the duodenum. Most cases of AP in adults remain asymptomatic. However, when AP is symptomatic, it is associated with vague abdominal symptoms. The primary management of symptomatic AP in adults involves surgical bypass of the annulus through performing gastrojejunostomy or duodenojejunostomy. While duodenoduodenostomy is less favorable, we opted for it due to the limitation of the obstruction to a specific segment of the duodenum. CONCLUSION This case underscores the importance of considering AP as a potential cause in the differential diagnosis of vague and persistent gastrointestinal symptoms. Moreover, most studies concerning the management of AP have consisted of case reports or small case series. This emphasizes the need for further studies to enhance our understanding of the most appropriate approach for managing each case of AP.
Collapse
Affiliation(s)
- Ali Alshiekh
- Department of Surgery, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic; Department of Surgery, Al-Assad University Hospital, Damascus University, Damascus, Syrian Arab Republic.
| | - M Fadi Alkurdi
- Department of Surgery, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic; Department of Surgery, Al-Assad University Hospital, Damascus University, Damascus, Syrian Arab Republic
| | - Rana Hadakie
- Department of Biochemistry and Microbiology, Faculty of Pharmacy, Damascus University, Damascus, Syrian Arab Republic
| | - Mohammed Alarsan
- Department of Surgery, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic; Department of Surgery, Al-Assad University Hospital, Damascus University, Damascus, Syrian Arab Republic
| | - Luna Sukkar
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Hamoud Hamed
- Department of Surgery, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic; Department of Surgery, Al-Assad University Hospital, Damascus University, Damascus, Syrian Arab Republic
| |
Collapse
|
2
|
Opramolla A, Gazzin A, Cisarò F, Pinon M, Calvo P, Rigazio C. Intestinal ultrasonography in pediatric population. Minerva Pediatr (Torino) 2024; 76:100-107. [PMID: 33871250 DOI: 10.23736/s2724-5276.21.06371-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Bowel ultrasound (US) is a low-cost, non-invasive, bed side practice and a reproducible procedure that represents a high yield tool in clinical practice and in the diagnostic workup of a consistent group of acute and chronic gastrointestinal (GI) tract disease. Moreover, in case of GI diseases of neonatal and pediatric age, it allows an easier evaluation due to the small body size and scarce presence of fat tissue in the abdominal wall and peritoneal cavity and gas content. No particular preparation of the patient is needed, nevertheless a 3- to 5-hour fasting state improves the quality of the examination. The exam focuses on wall thickness and stratification, lumen content, distensibility and compressibility, presence of peristalsis of explorable segment of the GI tract and includes the investigation of mesentery, perivisceral tissues and nodes features. Color doppler flowmetry admits a qualitative evaluation of GI wall and mesentery vascularization. Healthy GI wall appears at a US evaluation as a multilayered structure in which hyperechoic and hypoechoic layers alternate sequentially. In this article we provide a quickly available overview on findings, signs and applications of US in major GI pediatric diseases.
Collapse
Affiliation(s)
- Anna Opramolla
- Unit of Pediatric Gastroenterology, Department of Pediatrics, Città della Salute e della Scienza, Turin, Italy -
| | - Andrea Gazzin
- Department of Public Health and Pediatric Sciences, School of Medicine, University of Turin, Turin, Italy
| | - Fabio Cisarò
- Unit of Pediatric Gastroenterology, Department of Pediatrics, Città della Salute e della Scienza, Turin, Italy
| | - Michele Pinon
- Unit of Pediatric Gastroenterology, Department of Pediatrics, Città della Salute e della Scienza, Turin, Italy
| | - Pierluigi Calvo
- Unit of Pediatric Gastroenterology, Department of Pediatrics, Città della Salute e della Scienza, Turin, Italy
| | - Caterina Rigazio
- Unit of Pediatric Gastroenterology, Department of Pediatrics, Città della Salute e della Scienza, Turin, Italy
| |
Collapse
|
3
|
Yang JZ, Lim MC, Teo YM, Lee YY. Clinics in diagnostic imaging (218). Singapore Med J 2024; 65:45-50. [PMID: 38212984 PMCID: PMC10863738 DOI: 10.4103/singaporemedj.smj-2022-120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/29/2022] [Indexed: 01/13/2024]
Affiliation(s)
- James Zheng Yang
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Mei Chin Lim
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Yi Ming Teo
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Yang Yang Lee
- Department of Paediatric Surgery, National University Hospital, Singapore
| |
Collapse
|
4
|
Peng Z, Zhang M, Wang R, Huang H, Sun Z, Li Y. Giant duplication of the transverse colon in an adult: A case report and literature review. Open Life Sci 2023; 18:20220626. [PMID: 37333482 PMCID: PMC10276543 DOI: 10.1515/biol-2022-0626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/18/2023] [Accepted: 05/04/2023] [Indexed: 06/20/2023] Open
Abstract
Intestinal duplication is a rare congenital malformation that can occur in any segment of the digestive tract. It is most commonly found in the ileum of infants and is rarely reported in adults, especially in the colon. Diagnosing intestinal duplication can be extremely challenging due to its diverse clinical manifestations and complex anatomical structure. Surgical intervention is currently considered the mainstay of treatment. In this report, we presented a case of giant duplication of the transverse colon in an adult.
Collapse
Affiliation(s)
- Zhihao Peng
- Department of Emergency Surgery, Binzhou People’s Hospital, Binzhou256601, Shandong, China
| | - Mingkai Zhang
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou256603, Shandong, China
| | - Ruixue Wang
- Department of Pediatric Hematology and Endocrinology, Binzhou Medical University Hospital, Binzhou256603, Shandong, China
| | - Hai Huang
- Department of Burns and Plastic Surgery, Binzhou Medical University Hospital, Binzhou256603, Shandong, China
| | - Zongke Sun
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou256603, Shandong, China
| | - Yanbin Li
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou256603, Shandong, China
| |
Collapse
|
5
|
Zain L, Sweity R, Alshawwa K, Bannoura S, Jaber B, Abu-Zaydeh O. Pancreatic duplication cyst misdiagnosed as distal pancreatic tumor: A case report and surgical approach. Front Surg 2023; 10:1148308. [PMID: 36969761 PMCID: PMC10036569 DOI: 10.3389/fsurg.2023.1148308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
Enteric duplication cysts (EDCs) are a benign and uncommon congenital malformation, with a nonspecific and extremely variable clinical presentation. EDCs associated with the pancreas are called pancreatic duplication cysts (PDCs). They are especially rare and can present with recurrent abdominal pain or even severe pancreatitis. These cysts often get confused with pancreatic neoplasms or pseudocysts, thus posing diagnostic and surgical challenges. Here, we report a case of a 20-year-old male patient with a 14-year history of recurrent abdominal pain and many hospital admissions, who had several imaging studies revealing a persistent focal heterogeneous lesion affecting the tail of the pancreas, surrounding a small pseudocyst. An ultrasound (U/S) guided biopsy was avoided due to the location of the mass. Surgical resection was carried out for the suspicion of malignancy and final pathology report showed benign findings while revealing that what was thought to be a pseudocyst turned out to be a gastric-type PDC, and after reviewing the available literature, we encountered 16 similar cases regarding misdiagnosing PDCs. We conclude that PDCs are very rare and have a variable clinical presentation as well as a likelihood of being confused with other pancreatic neoplasms. Therefore, PDCs need a high index of suspicion to avoid recurrent hospital admissions and unnecessary procedures due to the fact that sometimes a simple cystectomy is adequate.
Collapse
Affiliation(s)
- Lara Zain
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Raghad Sweity
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Khaled Alshawwa
- Department of General Surgery, Al-Makassed Charitable Society Hospital, Jerusalem, Palestine
- Correspondence: Khaled Alshawwa
| | - Sami Bannoura
- Department of Pathology, Al-Makassed Islamic Charitable Society Hospital, Jerusalem, Palestine
| | - Bashar Jaber
- Department of General Surgery, Al-Makassed Charitable Society Hospital, Jerusalem, Palestine
| | - Omar Abu-Zaydeh
- Department of General Surgery, Al-Makassed Charitable Society Hospital, Jerusalem, Palestine
| |
Collapse
|
6
|
Imaging congenital anomalies of the ileum in adults:a pictorial review. Abdom Radiol (NY) 2023; 48:502-509. [PMID: 36401130 DOI: 10.1007/s00261-022-03739-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022]
Abstract
The ileal loops are anatomical location for the majority of congenital anomalies affecting the gastrointestinal tract. These include Meckel's diverticulum, ileal duplication, dysgenesis, atresia, mucosal diaphragm, and malposition of the ileum. Symptomatic lesions that often present with abdominal pain, intestinal obstruction or bleeding are usually diagnosed and treated during infancy and childhood. However, many of these congenital conditions may remain clinically silent and detected incidentally in adults undergoing radiological evaluation for unrelated medical reasons. This article presents the spectrum of the congenital ileal anomalies and their distinct features on small bowel examination and CT of the abdomen.
Collapse
|
7
|
Dajenah M, Ahmed F, Almohtadi A, Thabet A, Ghaleb K, Al-Yousofy F, Mohammed F. Cecal duplication cyst presenting with acute abdomen: a case report. Pan Afr Med J 2022; 41:280. [PMID: 35784599 PMCID: PMC9206177 DOI: 10.11604/pamj.2022.41.280.33731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/01/2022] [Indexed: 11/11/2022] Open
Abstract
Cecal duplication cyst is a rare congenital malformation with a few reported adult cases. We present a 23-year-old man who presented with low-grade fever, constipation, and right lower quadrant pain for three days. An abdominal computed tomography scan showed a cystic mass of 8.8x7.5x6 cm adjoining to the posterior wall of the cecum. The patient underwent abdominal laparotomy, and a right hemicolectomy was performed with resection of the duplication cyst. The histopathological study confirmed the diagnosis of a non-communicating cecal duplication cyst. In conclusion, it is essential to include cecal duplication cyst in the differential diagnosis of the acute abdomen to guarantee the best treatment strategy.
Collapse
Affiliation(s)
- Menawar Dajenah
- Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Faisal Ahmed
- Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Abdullatif Almohtadi
- Department of Radiology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Anessa Thabet
- Department of Gynecology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Khaled Ghaleb
- Department of Internal Medicine, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| | - Fayed Al-Yousofy
- Department of Pathology, Faculty of Medicine, Taiz University of Medical Science, Taiz, Yemen
| | - Fawaz Mohammed
- Department of Orthopedy, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
| |
Collapse
|
8
|
Gandhi D, Garg T, Shah J, Sawhney H, Crowder BJ, Nagar A. Gastrointestinal duplication cysts: what a radiologist needs to know. Abdom Radiol (NY) 2022; 47:13-27. [PMID: 34417830 DOI: 10.1007/s00261-021-03239-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 12/13/2022]
Abstract
Gastrointestinal tract duplication cysts are rare congenital malformations which can be diagnosed as early as the prenatal period but are frequently found in infancy or incidentally in adulthood. They can be seen throughout the alimentary tract with the most common involving the distal ileum and second most common the esophagus. Many duplication cysts are asymptomatic and thus discovered as an incidental imaging finding, though they can also be symptomatic with an array of clinical presentations dependent largely on their location. The vast majority of duplication cysts are benign; however, there are rare instances of malignant transformation reported. The aim of this review is to show how multimodality imaging can help in the diagnosis of duplication cysts at various anatomical locations. Duplication cyst can become symptomatic and in rare cases undergo malignant transformation; therefore, they are typically managed with surgical excision, particularly if found prenatally or during infancy. Given the diversity of anatomic locations, multiple differential diagnoses, and the need for surgical intervention, it is valuable to comprehend the role of multimodality imaging role in diagnosing duplication cysts.
Collapse
Affiliation(s)
- Darshan Gandhi
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 N St. Clair St, Suite 800, Chicago, IL, 60611, USA.
| | - Tushar Garg
- Department of Radiology, Seth GS Medical College & KEM Hospital, Acharya Donde Marg, Parel East, Parel, Mumbai, Maharashtra, 400012, India
| | - Jignesh Shah
- Department of Pediatric Radiology, University of Tennessee Health Science Center, Memphis, TN, 38103, USA
| | - Harpreet Sawhney
- Department of Radiology, Bridgeport Hospital at Yale New Haven Health, 167 Grant St, Bridgeport, CT, 06610, USA
| | - Benjamin James Crowder
- Department of Radiology, The Ohio State University Wexner Medical Center, 395W, 12th Av, 4th Floor, Columbus, OH, 43210, USA
| | - Arpit Nagar
- Department of Radiology, The Ohio State University Wexner Medical Center, 395W, 12th Av, 4th Floor, Columbus, OH, 43210, USA
| |
Collapse
|
9
|
Ghahremani GG. Radiological features and clinical implications of persistent congenital mesocolon: Pictorial essay. J Med Imaging Radiat Oncol 2021; 66:385-390. [PMID: 34747133 DOI: 10.1111/1754-9485.13347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/23/2021] [Indexed: 11/30/2022]
Abstract
In human foetus, the mesenteries that carry vascular and neural supply to the alimentary tube play an important role in its development and anatomical location within the abdominal cavity. The mesenteric attachments of the small bowel, transverse colon and sigmoid allow them to be intraperitoneally mobile structures. In contrast, the ascending and descending colon lose their mesenteries by fusion with the parietal peritoneum and become fixed in retroperitoneal position along the posterolateral walls of the abdomen. In about 2%-4% of individuals, this process is disrupted, causing a complete or partial retention of their congenital mesocolon. The ascending or descending colon will then remain intraperitoneally mobile, affecting the normal visceral anatomy and causing potential complications. This article reviews the spectrum of radiological manifestations and clinical consequences of these anomalies.
Collapse
Affiliation(s)
- Gary G Ghahremani
- Department of Radiology, University of California-San Diego Medical Center, San Diego, CA, USA
| |
Collapse
|
10
|
Yang CW, Che F, Liu XJ, Yin Y, Zhang B, Song B. Insight into gastrointestinal heterotopic pancreas: imaging evaluation and differential diagnosis. Insights Imaging 2021; 12:144. [PMID: 34674040 PMCID: PMC8531187 DOI: 10.1186/s13244-021-01089-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/29/2021] [Indexed: 02/08/2023] Open
Abstract
Heterotopic pancreas (HP) is an uncommon congenital abnormality in the developmental process of the pancreas, with gastrointestinal heterotopic pancreas (GHP) being the most common HP. The clinical manifestations of GHP may have variable patterns of presentation, dictated by both the anatomic location and the functional ability of the lesion. The most common imaging modality in detecting GHP is computed tomography (CT), while gastrointestinal barium fluoroscopy, endoscopic ultrasonography, and magnetic resonance imaging (MRI) are also applied. The density and enhancement patterns of GHP are consistent with histological classifications. GHP with a predominantly acinar tissue component manifests homogeneous and marked enhancement on CT images, whereas a predominantly ductal GHP presents heterogeneous and mild enhancement. On MRI, the appearance and signal intensity of GHP were paralleled to the normal pancreas on all sequences and were characterized by T1-weighted high signal and early marked enhancement. This article provides a comprehensive review of the histopathology, clinical manifestations, imaging features of various modalities, and differential diagnosis of GHP. It is hoped that this review will improve clinicians' knowledge of GHP and aid in accurate preoperative diagnosis, thereby reducing the misdiagnosis rate.
Collapse
Affiliation(s)
- Cai-Wei Yang
- West China School of Medicine, Sichuan University, Chengdu, 610041, China
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Feng Che
- West China School of Medicine, Sichuan University, Chengdu, 610041, China
| | - Xi-Jiao Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Yuan Yin
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Bo Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
| |
Collapse
|
11
|
Boulos AK, Long RA. Fussiness and New-Onset Diarrhea for 2 Weeks in a 9-week-old Girl. Pediatr Rev 2021; 42:562-565. [PMID: 34599056 DOI: 10.1542/pir.2020-002691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Andrew K Boulos
- University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX
| | - Rachel A Long
- University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX
| |
Collapse
|
12
|
Israrahmed A, Verma V, Ahmad S, Yadav RR. Ileal duplication cyst with giant polypoidal gastric heterotropia. BMJ Case Rep 2021; 14:e245333. [PMID: 34493562 PMCID: PMC8424841 DOI: 10.1136/bcr-2021-245333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/04/2022] Open
Abstract
Enteric duplication cysts (EDCs) are congenital malformations of the gastrointestinal tract. EDCs can present as tubular or spherical cystic lesions of the abdomen. The tubular variant of EDC arises as an outpouching from the bowel wall, whereas the spherical variant rarely shows bowel communication. EDCs are known to harbour heterotopic pancreatic parenchyma or gastric mucosa. We present a case of EDC of the ileum (tubular type) with heterotopic gastric mucosa in a 7-year-old child who came with malena and abdominal discomfort. CT revealed focal abnormal dilatation of the ileal loop with polypoidal mucosal thickening. Differential diagnosis of lymphoma, bowel polyps and Meckel's diverticula with gastric heterotopia (GH) were considered. Subsequent surgery followed by histopathology revealed it to be EDC with GH. We discuss this case to familiarise radiologists with the atypical imaging features of EDC, to prevent misdiagnosis and initiate prompt treatment in appropriate clinical settings.
Collapse
Affiliation(s)
- Amrin Israrahmed
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Vikrant Verma
- Pathology, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sarfraz Ahmad
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Rajanikant R Yadav
- Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| |
Collapse
|
13
|
D'Agostino V, Castaldo A, Catelli A, Pesce I, Genovese S, Coppola L, Monaci A, Esposito C, Amitrano M. An ileal duplication cyst case report: From diagnosis to treatment. Radiol Case Rep 2021; 16:1597-1602. [PMID: 33995750 PMCID: PMC8102431 DOI: 10.1016/j.radcr.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 12/30/2022] Open
Abstract
Enteric duplication cysts (EDCs) are rare congenital malformations of the children and can develop everywhere along the gastrointestinal (GI) tract, being the ileum the most frequent localization. We herein present an unusual case of duplication cyst of ileal origin who show a tubular morphology and doesn't communicate with GI lumen. A 2-month-old boy was admitted to our hospital for investigation of an anechoic formation of the lower right abdomen for the surgical planning. The patient was asymptomatic. Ultrasound (US) and magnetic resonance imaging (MRI) showed features of a cystic lesion. Laparoscopic surgery was performed and the cyst excised. Macroscopic examination and histologic findings confirmed the diagnosis of a enteric duplication cyst arising from the ileum. In a patient with an abdominal cystic mass, although asymptomatic, it's worth assessing the nature of the lesion and planning a surgery in order to avoid future complications. A correct use of diagnostic it's fundamental to identify the etiology and the characteristics of a cystic mass.
Collapse
Affiliation(s)
- Valerio D'Agostino
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Anna Castaldo
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Antonio Catelli
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Ilaria Pesce
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Stefano Genovese
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Luigi Coppola
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Alessandro Monaci
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Ciro Esposito
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| | - Michele Amitrano
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples, Italy
| |
Collapse
|
14
|
Nayak S, Reddy V, Eemaraka N, Jasmine Y. Intestinal duplication in an elderly-male presented as sigmoid volvulus. FORMOSAN JOURNAL OF SURGERY 2021. [DOI: 10.4103/fjs.fjs_60_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
15
|
Rahul S, Keshri R, Prasad R, Chaubey D, Hasan Z, Kumar V, Thakur V, Yadav R, Kumar R, Bakhtiyar A. Duplications of the alimentary tract in infants and children. FORMOSAN JOURNAL OF SURGERY 2021. [DOI: 10.4103/fjs.fjs_137_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
16
|
Kaur R, Dalal U, Kaur A. Rectal duplication cyst: a rare surgical case in a child. ANZ J Surg 2020; 91:E415-E416. [PMID: 33227169 DOI: 10.1111/ans.16460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/24/2020] [Accepted: 10/28/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Usha Dalal
- Department of General Surgery, Government Medical College and Hospital, Chandigarh, India
| | - Arshpreet Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| |
Collapse
|
17
|
No way out: Causes of duodenal and gastric outlet obstruction. Clin Imaging 2020; 65:37-46. [DOI: 10.1016/j.clinimag.2020.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/26/2020] [Accepted: 04/07/2020] [Indexed: 11/17/2022]
|
18
|
Kim SH, Cho YH, Kim HY. Alimentary Tract Duplication in Pediatric Patients: Its Distinct Clinical Features and Managements. Pediatr Gastroenterol Hepatol Nutr 2020; 23:423-429. [PMID: 32953637 PMCID: PMC7481056 DOI: 10.5223/pghn.2020.23.5.423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. METHODS We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. RESULTS A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). CONCLUSION ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.
Collapse
Affiliation(s)
- Soo-Hong Kim
- Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea
| | - Yong-Hoon Cho
- Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea
| | - Hae-Young Kim
- Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea
| |
Collapse
|
19
|
Abstract
Congenital and hereditary cystic lesions of the abdomen are relatively rare. Correct diagnosis is critical as they may simulate several other benign and malignant acquired diseases of the abdomen. With the correct and appropriate use of imaging, diagnosis may be relatively straightforward and clinical management may be implemented appropriately. The purpose of this article is to describe imaging findings of common and uncommon congenital and hereditary cystic disease of the abdominal organs.
Collapse
|
20
|
Wood CG, Lopes Vendrami C, Craig E, Mittal PK, Miller FH. Pancreatitis in the developmentally anomalous pancreas. Abdom Radiol (NY) 2020; 45:1316-1323. [PMID: 31468154 DOI: 10.1007/s00261-019-02197-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Developmental anomalies of the pancreas include more common entities such as pancreas divisum and annular pancreas, and unusual entities such as heterotopic pancreas. While these anomalies can present a diagnostic challenge to the radiologist, when the pancreatic tissue involved in these processes develops pancreatitis, the radiographic appearance can present a diagnostic dilemma. Awareness of these pancreatic anomalies and familiarity with their appearance when inflamed is necessary to distinguish pancreatitis in the developmentally anomalous pancreas from other inflammatory or neoplastic processes.
Collapse
Affiliation(s)
- Cecil G Wood
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Camila Lopes Vendrami
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Elizabeth Craig
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Pardeep K Mittal
- Department of Radiology and Imaging, Medical College of Georgia, 1120 15th Street BA-1411, Augusta, GA, 30912, USA
| | - Frank H Miller
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St. Suite 800, Chicago, IL, 60611, USA.
| |
Collapse
|
21
|
Hung ND, Tuan TA, Sy TV, Thinh VD, Ngoc VTN, Nga VT, Than VT. Torsion of Ileum Due To Giant Meckel's Diverticulum - A Case Report. Open Access Maced J Med Sci 2019; 7:4432-4434. [PMID: 32215108 PMCID: PMC7084003 DOI: 10.3889/oamjms.2019.876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Meckel’s diverticulum (MD) is detected in approximately 2% of all individuals and only 2-4% MD patients may develop symptoms. Small intestinal obstruction is a frequent complication in adults. CASE REPORT: A 48-year-old male was admitted to emergency department for high intestinal obstruction symptoms. The imaging examinations were failed to detect the underlying causes. A median laparotomy revealed small bowel obstruction (SBO) due to a segment of ileum twisted around a giant MD axis. CONCLUSION: Thus, a giant MD generating torsion of ileum is an unusual complication. Preoperative diagnosis is challenging. Emergency surgery is preferred to make an accurate diagnosis and for treatment.
Collapse
Affiliation(s)
- Nguyen Duy Hung
- Department of Radiology, Hanoi Medical University, Hanoi, Vietnam.,Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam
| | - Trinh Anh Tuan
- Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam
| | - Than Van Sy
- Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam
| | - Vu Duc Thinh
- Digestive Surgery Department, Viet Duc Hospital, Hanoi, Vietnam
| | | | - Vu Thi Nga
- Institute for Research and Development, Duy Tan University, Danang, Vietnam
| | - Van Thai Than
- NTT Institute of High Technology, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| |
Collapse
|
22
|
Sah VP, Anand U, Chaudhary B, Priyadarshi RN, Kumar R. Patent Vitellointestinal Duct Presenting as a Paraumbilical Abscess Along with Intestinal Obstruction in an Adult: a Case Report. Indian J Surg 2019; 81:502-504. [DOI: 10.1007/s12262-019-01884-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/02/2019] [Indexed: 10/27/2022] Open
|
23
|
Holland JC, Smith C, O'Shea M, Stewart J, Ockleford C, Finn GM. The anatomical society core embryology syllabus for undergraduate medicine. J Anat 2019; 235:847-860. [PMID: 31218692 PMCID: PMC6742929 DOI: 10.1111/joa.13023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 11/26/2022] Open
Abstract
A modified Delphi methodology was used to develop a consensus regarding a series of learning outcome statements to act as the foundation of an undergraduate medical core embryology syllabus. A Delphi panel was formed by recruiting stakeholders with experience in leading undergraduate teaching of medical students. The panel (n = 18), including anatomists, embryologists and practising clinicians, were nominated by members of Council and/or the Education Committee of the Anatomical Society. Following development of an a priori set of learning outcome statements (n = 62) by the authors, panel members were asked in the first of a two-stage process to 'accept', 'reject' or 'modify' each learning outcome, to propose additional outcomes if desired. In the second stage, the panel was asked to either accept or reject 16 statements which had either been modified, or had failed to reach consensus, during the first Delphi round. Overall, 61 of 62 learning outcome statements, each linked to examples of clinical conditions to provide context, achieved an 80% level of agreement following the modified Delphi process and were therefore deemed accepted for inclusion within the syllabus. The proposed syllabus allows for flexibility within individual curricula, while still prioritising and focusing on the core level of knowledge of embryological processes by presenting the essential elements to all newly qualified doctors, regardless of their subsequent chosen specialty.
Collapse
Affiliation(s)
| | - Claire Smith
- Brighton & Sussex Medical SchoolUniversity of SussexBrightonUK
| | - Marié O'Shea
- RCSI Health Professions Education CentreDublinIreland
| | - Jane Stewart
- Clinical EducationNewcastle UniversityNewcastleUK
| | | | - Gabrielle M. Finn
- Health Professions Education UnitHull York Medical SchoolHeslingtonYorkUK
| |
Collapse
|
24
|
Parra-Fariñas C, Quiroga-Gomez S, Castro-Boix S, Vallribera-Valls F, Castellà-Fierro E. Computed tomography of complicated Meckel's diverticulum in adults. RADIOLOGIA 2019. [DOI: 10.1016/j.rxeng.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
25
|
Tomografía computarizada del divertículo de Meckel complicado en adultos. RADIOLOGIA 2019; 61:297-305. [DOI: 10.1016/j.rx.2018.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 08/15/2018] [Accepted: 10/21/2018] [Indexed: 11/21/2022]
|
26
|
Martini C, Pagano P, Perrone G, Bresciani P, Dell'Abate P. Intestinal duplications: incidentally ileum duplication cyst in young female. BJR Case Rep 2019; 5:20180077. [PMID: 31555466 PMCID: PMC6750633 DOI: 10.1259/bjrcr.20180077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 01/14/2019] [Accepted: 01/25/2019] [Indexed: 01/26/2023] Open
Abstract
Gastrointestinal tract duplication is a rare congenital malformation in young patients and in adults, that occur anywhere from the mouth to the anus and their macroscopic structure may be cystic or tubular. Intestinal duplication does not show specific symptoms, indeed they can present with a variety of symptoms including abdominal distension and pain, sickness, hemorrhage, chronic respiratory disorders, as well as non-painful abdominal mass. Nonetheless, intestinal duplication can remain completely asymptomatic and be diagnosed as an incidental finding. Presentation with acute complications such as intestinal invagination or mechanical occlusion is quite rare. We present a case of asymptomatic ileum duplication cyst in young female who referred to the emergency department for trauma and was screened by eco-Focus Assessment Sonography for Trauma (eco-FAST), followed by MR and CT. The patient underwent ileal resection and prophylactic appendicectomy with ileo-cecal termino-lateral anastomosis. In this case, the intestinal duplication cyst was an asymptomatic incidental finding.
Collapse
Affiliation(s)
- Chiara Martini
- Diagnostic Department, University Hospital of Parma, via Gramsci 14, 43100 Parma, Italy
| | - Paolo Pagano
- Diagnostic Department, University Hospital of Parma, via Gramsci 14, 43100 Parma, Italy
| | - Gennaro Perrone
- Emergency Surgery, University Hospital of Parma, via Gramsci 14, 43100 Parma, Italy
| | - Paolo Bresciani
- Diagnostic Department, University Hospital of Parma, via Gramsci 14, 43100 Parma, Italy
| | - Paolo Dell'Abate
- Emergency Surgery, University Hospital of Parma, via Gramsci 14, 43100 Parma, Italy
| |
Collapse
|
27
|
Osorio JH, Trujillo JH, Gutiérrez JD, Cardona LF, Carvallo LM. Vólvulo gástrico, abordaje por laparotomía y laparoscopia. Revisión de la literatura a raíz de dos casos. REVISTA COLOMBIANA DE CIRUGÍA 2019. [DOI: 10.30944/20117582.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
28
|
Sangüesa Nebot C, Llorens Salvador R, Carazo Palacios E, Picó Aliaga S, Ibañez Pradas V. Enteric duplication cysts in children: varied presentations, varied imaging findings. Insights Imaging 2018; 9:1097-1106. [PMID: 30311079 PMCID: PMC6269332 DOI: 10.1007/s13244-018-0660-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/05/2018] [Accepted: 09/18/2018] [Indexed: 02/06/2023] Open
Abstract
Enteric duplication cysts (EDCs) are rare congenital malformations formed during the embryonic development of the digestive tract. They are usually detected prenatally or in the first years of life. The size, location, type, mucosal pattern and presence of complications produce a varied clinical presentation and different imaging findings. Ultrasonography (US) is the most used imaging method for diagnosis. Magnetic resonance (MR) and computed tomography (CT) are less frequently used, but can be helpful in cases of difficult surgical approach. Conservative surgery is the treatment of choice. Pathology confirms the intestinal origin of the cyst, showing a layer of smooth muscle in the wall and an epithelial lining inside, resembling some part of the gastrointestinal tract (GT). We review the different forms of presentation of the EDCs, showing both the typical and atypical imaging findings with the different imaging techniques. We correlate the imaging findings with the surgical results and the final pathological features. TEACHING POINTS: • EDCs are rare congenital anomalies from the digestive tract with uncertain pathogenesis. • More frequently, diagnosis is antenatal, with most EDCs occurring in the distal ileum. • Ultrasonography is the method of choice for diagnosis of EDCs. • Complicated EDCs can show atypical imaging findings. • Surgery is necessary to avoid complications.
Collapse
Affiliation(s)
- Cinta Sangüesa Nebot
- Radiology Department, Paediatric Imaging Section, Hospital Universitario y Politécnico La Fe, Avenida Fernando Abril Martorell 106, 46026, Valencia, Spain.
| | - Roberto Llorens Salvador
- Radiology Department, Paediatric Imaging Section, Hospital Universitario y Politécnico La Fe, Avenida Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Elena Carazo Palacios
- Paediatric Surgery Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Sara Picó Aliaga
- Radiology Department, Paediatric Imaging Section, Hospital Universitario y Politécnico La Fe, Avenida Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Vicente Ibañez Pradas
- Paediatric Surgery Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| |
Collapse
|
29
|
Xiao-Ming A, Jin-Jing L, Li-Chen H, Lu-Lu H, Xiong Y, Hong-Hai Z, Nian-Yin Y. A huge completely isolated duplication cyst complicated by torsion and lined by 3 different mucosal epithelial components in an adult: A case report. Medicine (Baltimore) 2018; 97:e13005. [PMID: 30383655 PMCID: PMC6221613 DOI: 10.1097/md.0000000000013005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
RATIONALE Intestinal or enteric duplication (ED) does exit as a rare congenital malformation of the gastrointestinal system clinically. It is a separate entity, but can be communicated with the gastrointestinal tract. It is characterized by a well-developed muscular wall and lumen endowed with ectopic mucosa, simulating a portion of normal bowel. A completely isolated duplication cyst (CIDC) refers to an extremely uncommon variant of ED, which is secluded from the alimentary tract and possesses its own exclusive blood supply. Surgical procedure is the treatment of choice, because most often, a definitive diagnosis can only be confirmed intraoperatively. PATIENT CONCERNS A 20-year-old male patient presented with a 10-day history of intermittent episodes of abdominal pain. The pain evolved from dull into progressive and intolerable, accompanied by vomiting, nausea, and abdominal distention. DIAGNOSES Closed-loop small-bowel obstruction with volvulus. INTERVENTIONS The patient underwent an emergency exploratory laparotomy. OUTCOMES A huge CIDC was observed upon operation, which was affixed to the mesentery with only a narrow base, just like a pedicle; 720° counterclockwise twisting around its base was definitely noted, provoking the compromised blood supply. Complete excision of the cyst was performed along its base safely without violating the intestinal tract. Furthermore, the ectopic mucosa of the cyst exhibited 3 different epithelial lining components histopathologically. LESSONS Clinicians should be aware of the possibility of the existence of a duplication and raise a high index of suspicion in case of equivocal diagnosis, particularly in adult population. A low threshold for surgical management should be recommended in order to prevent lethal outcomes.
Collapse
|
30
|
Yang T, Zou Y, Li J, Yang J, Tan T, Pan J, Hu C. Laparoscopic excision of an atypical Meckel's diverticulum. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
31
|
Demir MK, Savas Y, Furuncuoglu Y, Cevher T, Demiral S, Tabandeh B, Aslan M. Imaging Findings of the Unusual Presentations, Associations and Clinical Mimics of Acute Appendicitis. Eurasian J Med 2017; 49:198-203. [PMID: 29123444 DOI: 10.5152/eurasianjmed.2017.17218] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome. Familiarity with these entities may improve diagnostic accuracy and enable the quickest and most appropriate clinical management.
Collapse
Affiliation(s)
- Mustafa Kemal Demir
- Department of Radiology, Bahçeşehir University School of Medicine, Göztepe Medical Park Hospital, İstanbul, Turkey
| | - Yildiray Savas
- Department of Radiology, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Yavuz Furuncuoglu
- Department of Internal Medicine, Bahçeşehir University School of Medicine, Göztepe Medical Park Hospital, İstanbul, Turkey
| | - Tarik Cevher
- Department of Surgery, Göztepe Medical Park Hospital, İstanbul, Turkey
| | - Serdar Demiral
- Department of Surgery, Atakent Acıbadem Hospital, İstanbul, Turkey
| | - Babek Tabandeh
- Department of Surgery, Bahçeşehir University School of Medicine, Göztepe Medical Park Hospital, İstanbul, Turkey
| | - Melisa Aslan
- Medical Student, Bahcesehir University School of Medicine, İstanbul, Turkey
| |
Collapse
|
32
|
Rezvani M, Menias C, Sandrasegaran K, Olpin JD, Elsayes KM, Shaaban AM. Heterotopic Pancreas: Histopathologic Features, Imaging Findings, and Complications. Radiographics 2017; 37:484-499. [PMID: 28287935 DOI: 10.1148/rg.2017160091] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Heterotopic pancreas is a congenital anomaly in which pancreatic tissue is anatomically separate from the main gland. The most common locations of this displacement include the upper gastrointestinal tract-specifically, the stomach, duodenum, and proximal jejunum. Less common sites are the esophagus, ileum, Meckel diverticulum, biliary tree, mesentery, and spleen. Uncomplicated heterotopic pancreas is typically asymptomatic, with the lesion being discovered incidentally during an unrelated surgery, during an imaging examination, or at autopsy. The most common computed tomographic appearance of heterotopic pancreas is that of a small oval intramural mass with microlobulated margins and an endoluminal growth pattern. The attenuation and enhancement characteristics of these lesions parallel their histologic composition. Acinus-dominant lesions demonstrate avid homogeneous enhancement after intravenous contrast material administration, whereas duct-dominant lesions are hypovascular and heterogeneous. At magnetic resonance imaging, the heterotopic pancreas is isointense to the orthotopic pancreas, with characteristic T1 hyperintensity and early avid enhancement after intravenous gadolinium-based contrast material administration. Heterotopic pancreatic tissue has a rudimentary ductal system in which an orifice is sometimes visible at imaging as a central umbilication of the lesion. Complications of heterotopic pancreas include pancreatitis, pseudocyst formation, malignant degeneration, gastrointestinal bleeding, bowel obstruction, and intussusception. Certain complications may be erroneously diagnosed as malignancy. Paraduodenal pancreatitis is thought to be due to cystic degeneration of heterotopic pancreatic tissue in the medial wall of the duodenum. Recognizing the characteristic imaging features of heterotopic pancreas aids in differentiating it from cancer and thus in avoiding unnecessary surgery. © RSNA, 2017.
Collapse
Affiliation(s)
- Maryam Rezvani
- From the Department of Radiology, University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132 (M.R., J.D.O., A.M.S.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M.); Department of Radiology, Indiana University School of Medicine, Indianapolis, Ind (K.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Christine Menias
- From the Department of Radiology, University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132 (M.R., J.D.O., A.M.S.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M.); Department of Radiology, Indiana University School of Medicine, Indianapolis, Ind (K.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Kumaresan Sandrasegaran
- From the Department of Radiology, University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132 (M.R., J.D.O., A.M.S.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M.); Department of Radiology, Indiana University School of Medicine, Indianapolis, Ind (K.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Jeffrey D Olpin
- From the Department of Radiology, University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132 (M.R., J.D.O., A.M.S.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M.); Department of Radiology, Indiana University School of Medicine, Indianapolis, Ind (K.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Khaled M Elsayes
- From the Department of Radiology, University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132 (M.R., J.D.O., A.M.S.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M.); Department of Radiology, Indiana University School of Medicine, Indianapolis, Ind (K.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| | - Akram M Shaaban
- From the Department of Radiology, University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132 (M.R., J.D.O., A.M.S.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M.); Department of Radiology, Indiana University School of Medicine, Indianapolis, Ind (K.S.); and Department of Radiology, MD Anderson Cancer Center, Houston, Tex (K.M.E.)
| |
Collapse
|
33
|
Reminiscing on Remnants: Imaging of Meckel Diverticulum and Its Complications in Adults. AJR Am J Roentgenol 2017; 209:W287-W296. [PMID: 28834452 DOI: 10.2214/ajr.17.18088] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Meckel diverticulum may become symptomatic if it is complicated by hemorrhage, intestinal obstruction, diverticulitis, or tumor. Although classically described in children, it is often missed in adults because of lack of suspicion and difficulty in detection. The purpose of this article is to review the imaging findings and management of Meckel diverticulum and its complications. CONCLUSION Although it is infrequently encountered incidentally, Meckel diverticulum should be considered especially when interpreting examinations for abdominal pain, small-bowel obstruction, and gastrointestinal bleeding.
Collapse
|
34
|
Sánchez-Carpintero de la Vega M, García Villar C. Estudios telemandados con control fluoroscópico del tracto digestivo superior: Técnicas e indicaciones. RADIOLOGIA 2017; 59:343-354. [DOI: 10.1016/j.rx.2016.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 10/18/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
|
35
|
Affiliation(s)
- Daisuke Yoshikawa
- Department of Gastroenterology and Hepatology, Sasebo City General Hospital, Sasebo, Japan
| | - Takuji Yamao
- Department of Gastroenterology and Hepatology, Sasebo City General Hospital, Sasebo, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
36
|
Small bowel diverticulitis: an imaging review of an uncommon entity. Emerg Radiol 2016; 24:195-205. [PMID: 27815648 DOI: 10.1007/s10140-016-1448-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 09/29/2016] [Indexed: 02/07/2023]
Abstract
In this review, we discuss the clinical and radiologic findings of small bowel diverticulosis, which is infrequently encountered during practice and far less common than colonic diverticulosis. Small bowel diverticulosis can present with a range of emergent symptomatic complications including diverticulitis, perforation, or hemorrhage. Here, we focus on the clinical features, pathogenesis, radiologic findings, and treatment of small bowel diverticulitis. Although not routinely considered in the differential diagnosis of an acute abdomen, prospective radiologic diagnosis of small bowel diverticulitis is important and can lead to conservative treatment thus preventing unnecessary exploratory laparotomy.
Collapse
|
37
|
Gale HI, Gee MS, Westra SJ, Nimkin K. Abdominal ultrasonography of the pediatric gastrointestinal tract. World J Radiol 2016; 8:656-667. [PMID: 27551336 PMCID: PMC4965350 DOI: 10.4329/wjr.v8.i7.656] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/11/2016] [Accepted: 06/03/2016] [Indexed: 02/06/2023] Open
Abstract
Ultrasound is an invaluable imaging modality in the evaluation of pediatric gastrointestinal pathology; it can provide real-time evaluation of the bowel without the need for sedation or intravenous contrast. Recent improvements in ultrasound technique can be utilized to improve detection of bowel pathology in children: Higher resolution probes, color Doppler, harmonic and panoramic imaging are excellent tools in this setting. Graded compression and cine clips provide dynamic information and oral and intravenous contrast agents aid in detection of bowel wall pathology. Ultrasound of the bowel in children is typically a targeted exam; common indications include evaluation for appendicitis, pyloric stenosis and intussusception. Bowel abnormalities that are detected prenatally can be evaluated after birth with ultrasound. Likewise, acquired conditions such as bowel hematoma, bowel infections and hernias can be detected with ultrasound. Rare bowel neoplasms, vascular disorders and foreign bodies may first be detected with sonography, as well. At some centers, comprehensive exams of the gastrointestinal tract are performed on children with inflammatory bowel disease and celiac disease to evaluate for disease activity or to confirm the diagnosis. The goal of this article is to review up-to-date imaging techniques, normal sonographic anatomy, and characteristic sonographic features of common and uncommon disorders affecting the gastrointestinal tract in children.
Collapse
|
38
|
Di Serafino M, Mercogliano C, Vallone G. Ultrasound evaluation of the enteric duplication cyst: the gut signature. J Ultrasound 2016; 19:131-3. [PMID: 27298642 PMCID: PMC4879013 DOI: 10.1007/s40477-015-0188-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 11/06/2015] [Indexed: 12/12/2022] Open
Abstract
Gastrointestinal duplication cyst is a rare congenital anomaly that may occur anywhere along the gastrointestinal tract from the tongue to the anus. Such cysts occur most commonly in the small bowel and about half are in the mesenteric border of the ileum. Such cystic duplications communicate only rarely with the intestinal lumen although the cysts are attached to the intestine and may even share a common wall with the adjacent alimentary tract. These lesions can vary in shape, being cystic or tubular, and often show the same structure of the adjacent normal bowel. It is usually asymptomatic and complications are rare but they may include obstruction by volvulus or intussusception, bleeding, infection, and perforation. When diagnosed these lesions should be surgically resected to avoid future possible complications. The authors present a case of enteric cystic duplication and its ultrasound appearance in a 12-month-old Caucasian female infant cause of acute abdominal pain and intestinal obstruction, thus requiring urgent surgery.
Collapse
Affiliation(s)
- Marco Di Serafino
- />Department of Emergency Radiology, San Carlo Hospital, UOC Radiologia AOR San Carlo, via Potito Petrone, 85100 Potenza, PZ Italy
| | | | - Gianfranco Vallone
- />Department of Pediatric Radiology, University Hospital Federico II, Naples, Italy
| |
Collapse
|
39
|
Gjeorgjievski M, Manickam P, Ghaith G, Cappell MS. Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts: Case Report and Comprehensive Review of 28 Cases Reported in the Literature. Medicine (Baltimore) 2016; 95:e3799. [PMID: 27258515 PMCID: PMC4900723 DOI: 10.1097/md.0000000000003799] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Analyze efficacy, safety of endoscopic therapy for duodenal duplication cysts (DDC) by comprehensively reviewing case reports.Tandem, independent, systematic, computerized, literature searches were performed via PubMed using medical subject headings or Keywords "cyst" and "duodenal" and "duplication"; or "cyst", and "endoscopy" or "endoscopic", and "therapy" or "decompression"; with reconciliation of generated references by two experts. Case report followed CARE guidelines.Literature review revealed 28 cases (mean = 1.3 ± 1.2 cases/report). Endoscopic therapy is increasingly reported recently (1984-1999: 3 cases, 2000-2015: 25 cases, P = 0.003, OR = 8.33, 95%-CI: 1.77-44.5). Fourteen (54%) of 26 patients were men (unknown-sex = 2). Mean age = 32.2 ± 18.3 years old. Procedure indications: acute pancreatitis-16, abdominal pain-8, jaundice-2, gastrointestinal (GI) obstruction-1, asymptomatic cyst-1. Mean maximal DDC dimension = 3.20 ± 1.53 cm (range, 1-6.5 cm). Endoscopic techniques included cyst puncture via needle knife papillotomy (NKP)/papillotome-18, snare resection of cyst-7, cystotome-2, and cyst needle aspiration/ligation-1. Endoscopic therapy was successful in all cases. Among 24 initially symptomatic patients, all remained asymptomatic post-therapy without relapses (mean follow-up = 36.5 ± 48.6 months, 3 others reported asymptomatic at follow-up of unknown duration; 1 initially asymptomatic patient remained asymptomatic 3 years post-therapy). Two complications occurred: mild intraprocedural duodenal bleeding related to NKP and treated locally endoscopically.A patient is reported who presented with vomiting, 15-kg-weight-loss, and profound dehydration for 1 month from extrinsic compression of duodenum by 14 × 6 cm DDC, underwent successful endosonographic cyst decompression with large fenestration of cyst and endoscopic aspiration of 1 L of fluid from cyst with rapid relief of symptoms. At endoscopy the DDC was intubated and visualized and random endoscopic mucosal biopsies were obtained to help exclude malignant or dysplastic DDC.Study limitations include retrospective literature review, potential reporting bias, limited patient number, variable follow-up.In conclusion, endoscopic therapy for DDC was efficacious in all 29 reported patients including current case, including patients presenting acutely with acute pancreatitis, or GI obstruction. Complications were rare and minor, suggesting that endoscopic therapy may be a useful alternative to surgery for nonmalignant DDC when performed by expert endoscopists.
Collapse
Affiliation(s)
- Mihajlo Gjeorgjievski
- From the Division of Gastroenterology & Hepatology, William Beaumont Hospital (MG, PM, GG, MSC); and Oakland University William Beaumont School of Medicine (GG, MSC), Royal Oak, MI
| | | | | | | |
Collapse
|
40
|
Yoneyama H, Kondo C, Yamasaki A, Nakanishi T, Sakai S. Comparison of situs ambiguous patterns between heterotaxy syndromes with polysplenia and asplenia. Eur J Radiol 2015; 84:2301-6. [DOI: 10.1016/j.ejrad.2015.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/09/2015] [Accepted: 08/04/2015] [Indexed: 01/22/2023]
|
41
|
Flores-Ríos E, Méndez-Díaz C, Rodríguez-García E, Pérez-Ramos T. Wandering spleen, gastric and pancreatic volvulus and right-sided descending and sigmoid colon. J Radiol Case Rep 2015; 9:18-25. [PMID: 26629290 DOI: 10.3941/jrcr.v9i10.2475] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Wandering spleen is a rare condition, characterized by a mobile spleen that is attached only by an elongated vascular pedicle, allowing it to migrate to any part of the abdomen or pelvis. Mesenteroaxial gastric volvulus usually occurs in children and may be associated with wandering spleen. Both entities result from abnormal laxity or absence of the peritoneal attachments due to abnormal fusion of the peritoneal mesenteries. Pancreatic volvulus is a very rare anomaly, with only a few isolated case reports described in association with wandering spleen. Anomalous right sided descending and sigmoid colon is a very rare entity and its association with wandering spleen has not been previously reported. We report a case of wandering spleen associated with mesenteroaxial gastric volvulus, pancreatic volvulus and rightward shift of the splenic flexure of the colon and right sided descending and sigmoid colon in a young female.
Collapse
Affiliation(s)
- Enrique Flores-Ríos
- Department of Radiology, Hospital Universitario de A Coruña, A Coruña, Spain
| | | | | | - Tania Pérez-Ramos
- Department of Radiology, Hospital Universitario de A Coruña, A Coruña, Spain
| |
Collapse
|
42
|
Abstract
Acute abdominal pain in childhood is a frequent reason for a medical consultation. The main diseases that lead to the clinical situation of acute abdomen show a significant age dependency. It is reasonable to group such ailments into three age categories: (1) the neonatal and infant period, (2) toddlerhood to kindergarten and (3) school age children. The task of the pediatric radiological examination is the differential diagnostic correlation of symptoms to the respective diseases. In children ultrasound is the appropriate method of choice.
Collapse
Affiliation(s)
- R Wunsch
- Abteilung Radiologie, Sonographie und Magnetresonanztomographie, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland,
| | | |
Collapse
|
43
|
Dusunceli Atman E, Erden A, Ustuner E, Uzun C, Bektas M. MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations. Korean J Radiol 2015; 16:1240-52. [PMID: 26576112 PMCID: PMC4644744 DOI: 10.3348/kjr.2015.16.6.1240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 07/16/2015] [Indexed: 12/22/2022] Open
Abstract
This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.
Collapse
Affiliation(s)
- Ebru Dusunceli Atman
- Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey
| | - Ayse Erden
- Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey
| | - Evren Ustuner
- Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey
| | - Caglar Uzun
- Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey
| | - Mehmet Bektas
- Department of Gastroenterology, Ankara University School of Medicine, Ankara 06100, Turkey
| |
Collapse
|
44
|
Sharma S, Yadav AK, Mandal AK, Zaheer S, Yadav DK, Samie A. Enteric Duplication Cysts in Children: A Clinicopathological Dilemma. J Clin Diagn Res 2015; 9:EC08-11. [PMID: 26435952 DOI: 10.7860/jcdr/2015/12929.6381] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 06/12/2015] [Indexed: 12/15/2022]
Abstract
AIM Enteric duplication cysts are rare and uncommon congenital malformations formed during the embryonic period of the development of human digestive system and are mainly encountered during infancy or early childhood, but seldom in adults. The clinical presentation is extremely variable depending upon its size, location and type. We present six cases of enteric duplication cysts with diverse clinico-pathological features. MATERIALS AND METHODS This study was carried out in the Department of Pathology and Department of Paediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India for a period of 2 years (January 2013 - December 2014). We retrospectively analyzed six patients of enteric duplication cysts based on data obtained, which consisted of patient's age, sex, clinical presentation, radiological features, operative findings and histopathology report. The data collected was analyzed by descriptive statistics. RESULTS Six children between age range of 3 days to 10 years had enteric duplication cysts. Two had ileal and one each were of pyloroduodenal, colonic and rectal duplication cyst. In one patient a presumptive diagnosis of enteric duplication cyst was made. Radiology played an important contributory role in diagnosis of these cysts in all the patients but histopathology proved to be gold standard for its confirmation. All these patients were managed by surgical excision. The postoperative and follow up period in all the cases was uneventful. CONCLUSION It is important to be aware and make a definitive diagnosis of this rare congenital anomaly as they can present in various clinical forms and can cause significant morbidity and even mortality if left untreated by causing life threatening complications.
Collapse
Affiliation(s)
- Sonam Sharma
- Senior Resident, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Amit K Yadav
- Assistant Professor, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Ashish K Mandal
- Director Professor & Head, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Sufian Zaheer
- Assistant Professor, Department of Pathology, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Devendra K Yadav
- Assistant Professor, Department of Paediatric Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| | - Amat Samie
- Senior Resident, Department of Paediatric Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital , New Delhi, India
| |
Collapse
|
45
|
Sefa T, Mikail C, Anil S, Umit G, Gokcen G. Duodenal duplication cyst extending into the posterior mediastinum. Int J Surg Case Rep 2015; 10:252-5. [PMID: 25732523 PMCID: PMC4429960 DOI: 10.1016/j.ijscr.2015.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/12/2015] [Accepted: 02/12/2015] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Duodenal duplication is a rare congenital malformation. Although more frequent in childhood, it is rarely observed in adulthood. Preoperative diagnosis can be difficult. PRESENTATION OF CASE We report a case of 42 year-old woman with duodenal duplication cyst situated in the posterior mediastinum, who was misdiagnosed even after a primary surgery. Detailed diagnostic workup and a second operation was done. DISCUSSION This article discusses the incidence of duodenal duplications, their types and clinical presentations, the radiologic and diagnostic features with different therapeutic options. CONCLUSION Duodenal and the other intestinal duplication cysts should be considered in the differential diagnosis of oral contrast enhanced intrathoracic lesions in thorocoabdominal computerised tomography imaging.
Collapse
Affiliation(s)
- Tuzun Sefa
- Ministry of Health Haseki Research and Training Hospital, Department of General Surgery, İstanbul, Turkey
| | - Cakir Mikail
- Ministry of Health Haseki Research and Training Hospital, Department of General Surgery, İstanbul, Turkey.
| | - Savas Anil
- Ministry of Health Haseki Research and Training Hospital, Department of General Surgery, İstanbul, Turkey
| | - Gur Umit
- Ministry of Health Haseki Research and Training Hospital, Department of General Surgery, İstanbul, Turkey
| | - Gundogdu Gokcen
- Istanbul University Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| |
Collapse
|
46
|
Bagade S, Khanna G. Imaging of omphalomesenteric duct remnants and related pathologies in children. Curr Probl Diagn Radiol 2015; 44:246-55. [PMID: 25823549 DOI: 10.1067/j.cpradiol.2014.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/23/2014] [Accepted: 12/29/2014] [Indexed: 01/01/2023]
Abstract
The omphalomesenteric duct (OMD) or the vitelline duct (VD) is the embryologic communication between the yolk sac and the primitive midgut. OMD or VD anomalies are a group of defects resulting from failure of involution of the OMD. Meckel diverticulum is the most common anomaly that results from failure of resorption of the OMD. Other less common anomalies seen in children include OMD fibrous band, fistula, sinus tract, cyst, and umbilical polyps. These OMD remnants can have variable clinical manifestations such as umbilical discharge, small bowel obstruction, gastrointestinal tract bleeding, or acute abdomen. This pictorial essay reviews the clinical presentation and imaging findings of the common and not so common complications of OMD remnants in the pediatric population.
Collapse
Affiliation(s)
- Swapnil Bagade
- Mallinckrodt Institute of Radiology, Washington University, St Louis, MO.
| | - Geetika Khanna
- Mallinckrodt Institute of Radiology, Washington University, St Louis, MO
| |
Collapse
|
47
|
Liu R, Adler DG. Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound. Endosc Ultrasound 2014; 3:152-60. [PMID: 25184121 PMCID: PMC4145475 DOI: 10.4103/2303-9027.138783] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 01/29/2014] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal tract duplication cysts are rare congenital gastrointestinal malformation in young patients and adults. They consist of foregut duplication cysts, small bowel duplication cysts, and large bowel duplication cysts. Endoscopic ultrasound (EUS) has been widely used as a modality for the evaluation and diagnosis of duplication cysts. EUS is the diagnostic tool of choice to investigate duplication cysts since it can distinguish between solid and cystic lesions. The question of whether or not to perform EUS-fine needle aspiration (EUS-FNA) on a lesion suspected of being a duplication cyst is controversial as these lesions can become infected with significant consequences, although EUS-FNA is often required to obtain a definitive diagnosis and to rule out more ominous lesions. This manuscript will review the literature on duplication cysts throughout the body and will also focus on the role of EUS and FNA with regards to these lesions.
Collapse
Affiliation(s)
- Roy Liu
- Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, Salt Lake City, Utah, USA
| | - Douglas G Adler
- Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, Salt Lake City, Utah, USA
| |
Collapse
|
48
|
Hossary SH, Zytoon AA, Eid M, Hamed A, Sharaan M, Ebrahim AAEM. MR cholangiopancreatography of the pancreas and biliary system: a review of the current applications. Curr Probl Diagn Radiol 2014; 43:1-13. [PMID: 24290199 DOI: 10.1067/j.cpradiol.2013.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
MR cholangiopancreatography (MRCP) is still a rapidly evolving technique, but it has been already accepted as clinically useful and is widely used to evaluate biliary or pancreatic diseases. The advantages of this technique are that it does not use contrast media or ionizing radiation, it is noninvasive and complication free, and the examination is relatively short. MRCP has high sensitivity and specificity for diagnosing biliary dilatation and for determining the site and cause of stenosis. With further improvements of hardware and technique, MRCP is expected to replace diagnostic endoscopic retrograde cholangiopancreatography to examine the biliary and pancreatic ducts in the near future. The other applications include evaluation of primary sclerosing cholangitis, stenosis after liver transplantation, and bilioenteric anastomoses. This article reviews the current applications of MRCP in the evaluation of the pancreas and the biliary system.
Collapse
|
49
|
|
50
|
Kotha VK, Khandelwal A, Saboo SS, Shanbhogue AKP, Virmani V, Marginean EC, Menias CO. Radiologist's perspective for the Meckel's diverticulum and its complications. Br J Radiol 2014; 87:20130743. [PMID: 24611767 PMCID: PMC4075535 DOI: 10.1259/bjr.20130743] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation.
Collapse
Affiliation(s)
- V K Kotha
- Department of Medical Imaging, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | | | | | | | | | | | | |
Collapse
|