Intestinal obstruction caused by a duplication cyst of the cecum in a neonate

Cecal Duplication Cyst: A New Surgical Intervention

This case report of an infant details a rare occurrence of a cecal duplication cyst causing bowel obstruction. It was successfully treated through an extra mucosal enucleation. The patient presented at 41 days of life, with two days picture of abdominal distension and recurrent non-bilious vomiting. The infant improved initially, but subsequently, he developed bilious vomiting. Further investigations revealed a suspected ileocolic intussusception and small bowel obstruction. Surgical exploration revealed a cecal duplication cyst. The cyst was enucleated, and closure of the seromuscular defect was done with an appendectomy. The patient had a smooth recovery postoperatively. Histopathology confirmed the presence of a duplication cyst with benign ectopic gastric tissue negative for malignancy. The patient was discharged without any complications.

Ileocecal duplication in children: a single-center experience of 115 cases

To evaluate the clinical features, surgical management, and prognosis of ileocecal duplication in children. A total of 115 patients diagnosed with ileocecal duplication at Beijing Children's Hospital between January 2010 and June 2021 were retrospectively reviewed. Ileocecal duplications were divided into ileal intraluminal (n = 41), ileal extraluminal (n = 24), ileocecal valve (n = 11), cecal intraluminal (n = 18), and cecal extraluminal (n = 3) types according to their locations. Median age at diagnosis was 9.5 (0.1-169.2) months. Intussusception was only observed preoperatively in patients with the ileal intraluminal (8/41), ileocecal valve (4/11), and cecal intraluminal (7/18) types (P = 0.004). Ileocecal resection and ileocolostomy and cyst excision without ileocecal resection were performed in 41 (35.7%) and 74 (64.3%) patients, respectively. The proportions of cyst excision without ileocecal resection performed in patients with different types were 78.0% (32/41), 91.7% (22/24), 27.3% (3/11), 27.8% (5/18), and 100.0% (3/3) (P < 0.001). Time of oral intake (P = 0.003) and hospital stay after surgery (P < 0.001) were significantly shorter in patients undergoing cyst excision without ileocecal resection. There were no significant differences in the complications, growth, and stool frequency (older than 4 years) between patients undergoing different surgical procedures. Regarding the stool consistency (older than 4 years), there was a lower proportion of dry stool in patients undergoing cyst excision (P = 0.008).

CONCLUSIONS

Ileocecal duplications at specific locations are prone to intussusception and can influence the surgical procedure choice. At mid-term follow-up, the children's growth and defecation patterns do not seem to be affected by ileocecal resection.

WHAT IS KNOWN

• How to address ileocecal duplication has always been challenging in clinical management. • Children who have an ileocecal resection can develop some early postoperative complications.

WHAT IS NEW

• Ileocecal duplications at specific locations are prone to intussusception and can influence the surgical procedure choice. • Children's growth and defecation patterns do not seem to be affected by ileocecal resection.

Caecal duplication, a case report

The caecum is one of the rarest sites of intestinal duplication cysts. The most common symptomatology includes vomiting, abdominal pain, abdominal distention, palpable mass and rectal bleeding. Most of the duplications are diagnosed within the first two years of life, including prenatal diagnosis. Only few cases of caecal duplication have been reported in the literature up to the present day. We are going to present a case of a five-years old girl with caecum duplication who reached our ward due to abdominal distension with no other symptoms.

Caecal duplication cyst: A rare disease with variable presentation and its management in the era of laparoscopy

Duplication cysts of the intestine are a rare congenital anomaly that can occur anywhere throughout the length of intestine and can be either cystic or tubular. Around two dozen cases of caecal duplication cyst (CDC) are reported in the literature with variable presentation. We describe three cases of CDC who presented at variable age and with variable presentation. None of the imaging study could confirm the site of the duplication, preoperatively. All patients underwent laparoscopy-assisted resection and anastomosis. All patients are free of any complications at median follow-up of 24 months.

Cecal duplication: A mimicker of intussusception: A case report and review

INTRODUCTION

Cecal duplication is a rare congenital anomaly and to the best of our knowledge, only 43 cases have been reported in the literature till date. Most of them present within the first year of life. They can mimic intussusception, and the delay in diagnosis can lead to high morbidity.

CASE REPORT

A five-year boy presented with pain abdomen for a week. He was found to have ileocolic intussusception. The intussusception could only be partially reduced by the hydrostatic method. On laparotomy, a submucosal solid mass was found in the cecum with multiple enlarged lymph nodes. Mass was resected with clear margins and lymph nodes sampled. Histopathology was conclusive of cecal duplication. Post-operative course was uneventful, and the child is thriving well, last reviewed at three-year follow-up.

CONCLUSION

Incomplete reduction of intussusception, intussusception with atypical presentation or intussusception in atypical age group should alert to the possibility of cecal duplication.