Dynamic change of intestinal duplication in an adult patient: a case report and literature review

Duplication cyst in adult cases: a journey from diagnosis to treatment

Duplication cysts are rare congenital abnormalities of the alimentary tract, typically manifesting symptoms in the first 2 years but uncommon in adults. Medical data on duplication cysts is scarce in Vietnam's Mekong Delta region. These two adult cases aim to provide fundamental knowledge, clinical characteristics, diagnosis, risks, complications, surgical and observational treatment methods, and future bilateral tumor research. Case 1: A 21-year-old male with intestinal obstruction symptoms. Computed tomography (CT)-scan revealed a strangulated small bowel obstruction with ischemia. Laparotomy discovered a twisted ileal duplication cyst causing necrosis in ~30 cm of the small intestine. Case 2: A 34-year-old woman hospitalized for right lower quadrant pain. CT-scan showed a cystic structure protruding into the ascending colon lumen. She underwent a laparoscopic right hemicolectomy, and an ascending colonic cyst was found in the specimen. Conclusions: Duplication cysts are rare anomalies, especially in adults. Comprehending and acquiring knowledge ensures prompt diagnosis and appropriate treatment.

A unique case of complete tubular colonic duplication with normal anus accompanied by vestibular fistula in a 12 years _ old _ girl - A case report

INTRODUCTION AND IMPORTANCE

Duplication of the digestive system is one of the rare cases, which can vary in shape and size and is cystic in 80 % of cases. Most cases of duplication are often diagnosed before the age of two years. There are many ways to make the diagnosis, with computed tomography being the best, and duplication is often diagnosed during surgery.

CASE PRESENTATION

We present the case of a child suffering from complete duplication of colon with normal anus, accompanied by vestibular fistula with double urethra and vagina. The diagnosis was made at our hospital, the necessary surgery was performed, and a future plan for the child's condition was developed. CLINICAL DISCUSSION: a colonic duplication may be associated with malformations of other organs, and sometimes it may be associated with a vestibular or vaginal fistula. Therefore, we must evaluate patients for other anomalies when diagnosing a duplication. The most appropriate diagnostic method is CT, and surgery is recommended in symptomatic or asymptomatic patients.

CONCLUSION

When keeping in mind the possibility of a duplication of the digestive system, the surgeon helps to plan the surgery well, in addition to the importance of informing the parents of the possibility of eradication.

Primary Cutaneous Enteric Duplication Cyst: A Novel Entity

ABSTRACT

Enteric duplication cysts (EDCs) are rare congenital malformations consisting of double-walled cystic or tubular structures lined by gastrointestinal type epithelium. EDCs share a common muscular wall and blood supply with the adjacent duplicated bowel with very rare exceptions. The majority of EDCs are intraabdominal with cases less commonly intrathoracic or thoracoabdominal. To the best of our knowledge, we present the first reported case of primary cutaneous EDC to occur outside the abdominal and thoracic cavities. A 17-year-old male without a significant medical or surgical history underwent excision of a cystic nodule on the left hip. On histopathology, a dermal to subcuticular cyst exhibited an epithelial lining with 2 distinct components including cuboidal to columnar mucinous cells (CK7+, CK20-, and CDX2-) and complex glandular colonic-type mucosa (CK7-, CK20+, and CDX2+). A thick muscular wall resembling muscularis mucosa and muscularis propria surrounded the cyst. Findings supported a primary cutaneous enteric duplication cyst of uncertain developmental etiology. The novel nature of this entity could represent a diagnostic challenge.

Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

Background

Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia.

Case presentation

We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period.

Conclusion

SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

A huge completely isolated duplication cyst complicated by torsion and lined by 3 different mucosal epithelial components in an adult: A case report

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.

Tubular colonic duplication in an adult: case report and brief literature review

Gastrointestinal tract duplication is a rare congenital anomaly that can occur anywhere along the alimentary tract. Most of the reported patients present with acute abdomen during childhood. We describe a case of tubular colonic duplication in an adult. The patient was a 25-year-old woman who presented with abdominal pain, bloating, nausea, and emesis for 3 days. The physical examination was remarkable for abdominal distension, tenderness, and rigidity. Abdominal computed tomography scan revealed abnormal intestinal dilatation. Exploratory laparotomy was performed, and tubular colonic duplication was identified intraoperatively. The diagnosis was verified by postoperative pathology results. The patient was discharged on postoperative day 14 and followed for 2 years without specific events or complications. Furthermore, we reviewed the published literature on colorectal duplication in adults for the past two decades.

A Midgut Duplication Cyst Lined by Respiratory Epithelium

Duplication cysts are an uncommon finding. Majority of these cases are found in the region of the midgut, and many have been reported in literature. However, there has been only one previous case of a midgut duplication cyst lined by respiratory epithelium. This is a rare pathology, of which very little is known about. The pathophysiology of these cases is also difficult to explain. We aim to present a case of a midgut duplication cyst in a paediatric patient, who had other abnormalities as well. We also aim to offer a hypothesis for this case.

Ileal Duplication Cyst Presenting With Acute Abdomen at Adult Age: Report of a Rare Case and a Review of the Literature

Gastrointestinal duplication cysts are rare lesions that typically present with acute abdomen in childhood. They are rare in adults, with only a few adult cases having been reported thus far. Adults with these lesions are usually asymptomatic or manifest with subtle abdominal symptoms. They may, however, also present with obstruction, bleeding, perforation, or malignancy. Herein, we aimed to report a case of ileal duplication cyst at adult age that presenting with symptoms of acute abdomen and reviewed the reported cases of adult age duplication cysts.

Tubular Duplication of the Midgut Presenting with Acute Abdomen and Hematochezia: A Case Report from Northern Tanzania

Enteric duplication is one of the rare malformations affecting the small intestine more than the other parts of the gastrointestinal tract. It poses a challenge in diagnosis due to nonspecific symptoms that may mimic other pathologies. Furthermore, the management options including total resection, mucosal striping, and internal drainage of the duplicate depend on the presentation of the patient, site, and length of the involved bowel. We present the first documented case of enteric duplication in Tanzania, a 3-year-old male, who was found to have a 90 cm long jejunoileal duplicate. We discuss the presentation and management offered.

Duplication cyst of ileum presenting as acute intestinal obstruction in an adult

Duplication cysts occur because of congenital aberration during gut development. They are commonly diagnosed during infancy and rarely during adulthood. We present an adult male who presented to surgical emergency with acute intestinal obstruction. Intraoperatively, this patient was found to have a non-communicating duplication cyst of ileum causing proximal obstruction. The involved segment of the small bowel was resected and a divided loop ileostomy was created.

Ileal duplication cyst in the elderly complicated by appendicitis: A rare case report and review of literature

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Duplication cysts seen commonly in the pediatric population is a rare entity in the elderly.

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Surgical resection is necessary due to possible complications.

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Laparoscopic management aids early recovery and minimum morbidity.

Introduction

Gastrointestinal duplication cysts are rare, generally found in infants and young adults. Adult presentation is rare.

Presentation of the case

We present an elderly lady who presented with right iliac fossa pain. Imaging showed a terminal ileal duplication cyst. Laparoscopic right hemicolectomy was done.

Histopathology confirmed ileal duplication cyst with reactive appendicitis.

Discussion

Surgical resection is deemed appropriate management due to known complications like obstruction, hemorrhage, perforation and malignant degeneration. Resection of only the cyst is adequate in completely isolated cases. However, others require resection of adjoining small bowel.

Conclusion

We highlight the rare occurrence in elderly and its management laparoscopically.

Double intestinal duplication and incidental neuroendocrine tumor of appendix, a rare case of acute abdomen

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We present a rare case of double intestinal duplication and incidental neuroendocrine tumor of appendix like acute abdomen.

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We discuss about the difficult in diagnostic imaging.

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We consider surgery mandatory for diagnosis and definitive therapy in these cases.

Introduction

Intestinal duplication is rarely reported in adulthood and often remains undiagnosed until onset of complications. We describe the case of a 39 year old woman who came to our observation for acute abdomen due to a combination of double intestinal duplication (colon and ileum) and an incidental neuroendocrine tumor of the appendix.

Materials and methods

A 39 year old woman who was admitted at with upper abdominal pain.

Multisliced spiral CT scan showed a cystic lesion suggestive of an inflammed Meckel’s diverticulum.The patient was underwent an urgent explorative laparoscopy.

The intraoperative findings revealed a cystic lesion of the anti-mesenteric side of transverse colon, apparently dissectable from the bowel and a second lesion with a strongly adherent and unresectable from the anti-mesenteric aspect of the small bowel. A combined appendectomy was also performed.

The histological diagnosis was consistent with a typical intestinal duplication for both intestinal lesionsand an incidental 2 mm carcinoid tumor was also found in the appendix.

The postoperative course was uneventful and the patient was discharged on p.o. day 5. At the presenttime she is well and following a regular oncologic follow-up.

Discussion

The rarity of this case is due to the concomitant presence of an incidental, sincronous, appendiceal NET.

The elective treatment is surgical resection.

Conclusion

Intestinal duplication in the adulthood is extremely rare and may either have an acute presentation as acute abdomen or represents an incidental finding of mass.

We suggest that, once the diagnosis is suspected patient must undergo surgery.

Ileal duplication: an unusual cause of intestinal obstruction in adult life

Gastrointestinal duplications are rare congenital malformations seldom diagnosed in adulthood. They may vary greatly in size and location, with the small intestine being their major focus. Their clinical presentation is widely variable and unspecific, mimicking more common pathologies, thus making preoperative diagnosis very difficult. The intraoperative surgeon's experience and knowledge are crucial in recognising these lesions so that they can be correctly managed. In this report, the authors present a case of a 36-year-old man with an acute intestinal obstruction as the first presentation of ileal duplication.

Congenital intestinal duplication in an adult

Congenital intestinal duplication is an anomaly most commonly diagnosed in children under the age of 2. Rarely, it is seen in adults who remain asymptomatic or present with vague abdominal symptoms. Here, we describe the case of a 33-year-old female who was diagnosed intraoperatively with congenital intestinal duplication after suffering from a year of vague abdominal complaints.

Enteric duplication cyst containing squamous and respiratory epithelium: an interesting case of a typically pediatric entity presenting in an adult patient

Enteric duplication cysts are rare congenital malformations that can occur at any point along the digestive tract, most commonly the small bowel. They are characterized by the presence of an outer layer of smooth muscle and an inner lining of mucosa that may resemble any portion of the digestive tract. Less commonly, cases have been reported that also contain mucosal components of nonintestinal origin. This entity is typically diagnosed in young children, but occasionally presents in adolescence and young adulthood. We present a rare case of a 21-year-old male who presented with nonspecific symptoms of abdominal discomfort and weight loss and was later found to have a 9 cm nonenhancing mass in the distal ileum on CT imaging. Laparoscopic dissection of the mass revealed a cystic lesion lined mainly by pseudostratified ciliated columnar respiratory-type epithelium, with patchy areas of squamous epithelium as well as villous columnar epithelium resembling small bowel. The unique histology and advanced patient age make this case a unique presentation of what is already a rare pathological entity.