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Powell A, Jones HE, Alazraki A, Lantis P. All Vomit Is Not Viral. Pediatr Ann 2023; 52:e273-e276. [PMID: 37427968 DOI: 10.3928/19382359-20230516-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Duplication cysts are congenital malformations of the gastrointestinal tract. They are rare, occurring in 1 in 4,500 births.1 Although the age of symptomatic onset is typically 2 years, current literature shows reports of presentation from newborn to adulthood. Presentation of duplication cysts may vary widely and can occur during outbreaks of acute infectious gastroenteritis cases. Thus, it is important to consider these cysts in the differential diagnosis of the vomiting child. We report the case of a 7-year-old boy with persistent bilious vomiting who was found to have a bilobed duplication cyst. [Pediatr Ann. 2023;52(7):e273-e276.].
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Shanmugalingam A, Duxbury H, Choi JDW, Kwik C, P'Ng CH, Kim L, Pathma-Nathan N. An unusual case of colonic duplication cyst in an adult with dysplasia. J Surg Case Rep 2023; 2023:rjad039. [PMID: 36824693 PMCID: PMC9943052 DOI: 10.1093/jscr/rjad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/17/2023] [Indexed: 02/25/2023] Open
Abstract
Duplication cysts are rare benign congenital malformations typically identified in children by the age of 2 years. We report a rare case of colonic duplication cyst with dysplasia in an adult. A 32-year-old male was diagnosed with non-specific abdominal symptoms. Abdominopelvic computed tomography scan demonstrated a submucosal cystic lesion in the right colon. He underwent laparoscopic right hemicolectomy. Histopathology showed colonic duplication cyst with low grade dysplasia. He is due for a surveillance colonoscopy in 3 years. Duplication cyst in an adult colon with dysplasia is extremely rare. They are usually present in the terminal ileum. They have non-specific abdominal symptoms or can be asymptomatic. They are often identified incidentally or intraoperatively. Imaging may demonstrate a cystic lesion. Histopathology is required for definitive diagnosis. There are no guidelines or consensus on managing duplication cysts in adults. We recommend an oncological resection of the involved colon. Surveillance with routine colonoscopy is advisable.
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Affiliation(s)
- Aswin Shanmugalingam
- Department of Colorectal Surgery, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia
| | - Hayley Duxbury
- Department of Tissue Pathology and Diagnostic Oncology, ICPMR, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia
| | - Joseph Do Woong Choi
- Department of Colorectal Surgery, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia
| | - Charlotte Kwik
- Department of Colorectal Surgery, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia
| | - Chow Heok P'Ng
- Department of Tissue Pathology and Diagnostic Oncology, ICPMR, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia
| | - Lauren Kim
- Department of Tissue Pathology and Diagnostic Oncology, ICPMR, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia
| | - Nimalan Pathma-Nathan
- Department of Colorectal Surgery, Westmead Hospital, Corner of Hawkesbury and Darcy Roads, Westmead, NSW 2145, Australia
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Ahmed S, Saifuddin MS, Ng CY, Salwati NF, Hayati F, Ismail S. Congenital colorectal tubular duplication in an infant: A tale of radiological diagnostic challenges. Radiol Case Rep 2021; 16:3289-3294. [PMID: 34484533 PMCID: PMC8403710 DOI: 10.1016/j.radcr.2021.07.081] [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: 07/11/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022] Open
Abstract
Enteric duplications (EDs) are rare congenital anomalies that result from defect during embryonic development of the gut. Although EDs can literally occur at any part of the gastrointestinal tract, ileocecal duplication is the commonest type followed by colorectal type. Morphologically, EDs are mostly cystic in nature; tubular duplications are uncommon. We report radiological diagnostic challenges encountered in dealing with a 10 month-old infant who presented with chronic constipation, progressive abdominal distension, and voiding difficulty for several weeks followed by colicky abdominal pain for three days. After a series of radiological procedures, a diagnosis of tubular colorectal duplication was made. The duplicated segment was loaded with impacted feces which exerted pressure effect on the rectum and urinary bladder. The case was treated surgically through laparoscopic procedure that included fenestration and stapling of the duplicated bowel followed by irrigation. Postoperatively, the child was followed up half-yearly for three years and was found to remain symptom-free. This case exemplifies the challenges a radiologist may experience while dealing with a case presenting with features of as acute-on-chronic intestinal obstruction and voiding difficulty.
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Affiliation(s)
- Selim Ahmed
- Paediatric Department, Medical Based Department, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | - Chiak Yot Ng
- Department of Radiology, Medical Based Department, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia
| | | | - Firdaus Hayati
- Department of Surgery, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Suseela Ismail
- Department of Radiology, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
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Radhakrishnan L, George J, Abraham LK. Right-Sided Colonic Duplication Cyst with a Malignant Twist in a Young Adult - a Case Report. J Gastrointest Cancer 2021; 53:805-808. [PMID: 34279795 DOI: 10.1007/s12029-021-00671-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Affiliation(s)
| | - Joseph George
- Department of Surgical Gastroenterology, Rajagiri Hospital, Aluva, Kerala, India
| | - Latha K Abraham
- Department of Pathology, Rajagiri Hospital, Aluva, Kerala, India.
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Bhat R, Choudhari RR, Prabhu S, Thejeswi P. Rare presentation of rectal duplication cyst as perineal hernia in an adult. BMJ Case Rep 2021; 14:14/4/e239879. [PMID: 33849866 PMCID: PMC8051395 DOI: 10.1136/bcr-2020-239879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rectal duplication cysts are rare congenital anomalies of the gastrointestinal tract. They can present with pain, gastrointestinal bleeding, infection or compressive symptoms on the rectum and urinary bladder. A 79-year-old man presented with a 8×5 cm swelling in the sacral region above the natal cleft with a positive cough impulse. During surgical exploration, there were two cysts with the posterior one presenting as the hernia. The cyst was excised and histopathological examination confirmed a diagnosis of rectal duplication cyst. Rectal duplications can lie anterior or more commonly posterior to the rectum. Differential diagnoses include dermoid cyst, diverticular cyst, sacrococcygeal teratoma or meningocele and endoscopic ultrasound is imaging of choice for diagnosis. Surgical excision is the treatment of choice. This is a rare presentation of a rectal duplication cyst as a perineal hernia with only a handful of cases in literature.
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Affiliation(s)
- Rahul Bhat
- Department of General Surgery, Kasturba Medical College Mangalore, Mangalore, Karnataka, India
| | | | - Shivananda Prabhu
- Department of General Surgery, Kasturba Medical College Mangalore, Mangalore, Karnataka, India
| | - Poornachandra Thejeswi
- Department of General Surgery, Kasturba Medical College Mangalore, Mangalore, Karnataka, India
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Li GB, Han JG, Wang ZJ, Zhai ZW, Tao Y. Successful management of tubular colonic duplication using a laparoscopic approach: A case report and review of the literature. World J Clin Cases 2020; 8:3291-3298. [PMID: 32874984 PMCID: PMC7441256 DOI: 10.12998/wjcc.v8.i15.3291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/25/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Alimentary duplication is a rare congenital disease with a reported incidence of 1 per 4500 persons, although the exact incidence has been difficult to ascertain. According to previous reports, the most common site of duplication is the ileum, and colonic duplication is rare. Due to different types and locations of the duplication, the manifestations are varied, which makes establishing an accurate diagnosis before surgery a challenge.
CASE SUMMARY A 17-year-old female patient sought evaluation in our department with constipation and chronic abdominal pain for 12 years; she had difficulty defecating and had dry stools since she was a child. An abdominal computed tomography revealed two extremely enlarged loops of bowel full of stool-like intestinal contents in the left lower abdomen, which led us to consider the possibility of colonic duplication. A laparoscopic exploration was performed, which revealed a tubular duplicated colon that shared a common opening with the transverse colon. A left hemi-colectomy was performed with a side-to-side anastomosis. The pathologic results confirmed the diagnosis. At the 6-mo follow-up, the patient was doing well without constipation or abdominal pain.
CONCLUSION Colonic duplication is a rare alimentary abnormality in adults. Due to the non-specific manifestations and low incidence, it is usually difficult to make an accurate diagnosis pre-operatively. Surgery is the mainstay of treatment, even though some patients are asymptomatic.
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Affiliation(s)
- Gan-Bin Li
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Jia-Gang Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Zhen-Jun Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Zhi-Wei Zhai
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Yu Tao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Carbonell Buj E, Billet JP, Vanel M, Caron A. Rectal duplication in an adult cat: a novel transanal surgical approach. JFMS Open Rep 2020; 6:2055116920916956. [PMID: 32528720 PMCID: PMC7263134 DOI: 10.1177/2055116920916956] [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] [Indexed: 11/16/2022] Open
Abstract
CASE SUMMARY A 3-year and 8-month-old male entire European domestic shorthair cat was presented with a history of recurrent rectal prolapse, straining and pain when defaecating. Previous non-surgical and surgical treatments had not provided a satisfactory result. Rectal prolapse had recurred within 2 weeks of treatment. Upon clinical examination, an intraluminal mass could be palpated rectally. A CT scan examination revealed the mass was of a cystic nature and the cyst was surgically excised via a transanal approach. On histological evaluation, the cyst walls consisted of three of the layers of normal rectum: mucosa, muscularis of the mucosa and submucosa. These findings led to the definite diagnosis of rectal duplication. RELEVANCE AND NOVEL INFORMATION Enteric duplication is among the differential diagnoses for straining and rectal prolapse in cats. This condition has previously been discussed in the veterinary literature, with a single case report describing a rectal duplication in a cat. In that particular case, the authors described a perineal surgical approach. Here we present a novel approach whereby the duplicated material was excised transanally in order to limit intra- and postoperative morbidity. The clinical outcome was excellent in our case, with complete resolution of clinical signs and no recurrence 18 months after surgery.
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Affiliation(s)
| | | | - Maïa Vanel
- Atlantia Veterinary Hospital Centre, Nantes, France
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Al-Shaibi MA, Raniga SB, Asghar ANM, Al Tubi IS. Caecal duplication cyst leading to intussusception in an adult. BMJ Case Rep 2019; 12:e230567. [PMID: 31511265 PMCID: PMC6738667 DOI: 10.1136/bcr-2019-230567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2019] [Indexed: 12/12/2022] Open
Abstract
Colonic duplication cyst is an uncommon cause of intussusception in adults. We report a case of caecal duplication cyst in a 24-year-old adult with a 3-year history of recurrent abdominal pain mainly in the periumbilical region. CT and MRI of the abdomen showed a lesion suggesting an caecal duplication cyst within an intussuception. The patient underwent diagnostic laparoscopy and was found to have a caecal duplication cyst acting as a lead point for the intusseception for which laparoscopic-assisted resection was performed. The histological examination confirmed the presence of intestinal duplication cyst without any underlying malignancy.
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Affiliation(s)
- Maha A Al-Shaibi
- Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sameer B Raniga
- Radiology Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Abdul N M Asghar
- Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ikhtiyar S Al Tubi
- Department of General Surgery, Oman Medical Speciality Board, Al-Athaiba, Oman
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Sotoodehnia S, Azizi R, Darabi ME, Moazzami B, Jesmi F, Sheikhvatan M. Congenital Tubular Duplication of Colon in an Adult Presented by Abdominal Pain and Constipation: A Case Report and Review of the Literature. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018; In Press. [DOI: 10.5812/ircmj.84205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
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