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Miry N, Karich N, Bakhti M, Deflaoui T, Bennani A. Unusual Presentation of an Ileal Duplication Cyst: A Case Report. Cureus 2023; 15:e38959. [PMID: 37313060 PMCID: PMC10258869 DOI: 10.7759/cureus.38959] [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] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
Duplication cyst (DC) of the digestive tract is a rare embryological anomaly, presenting as a cystic formation that could be attached to any part of the digestive tract, it is a thin-walled structure made of two layers, an inner layer that is frequently lined by an alimentary epithelium, surrounded by a smooth muscle layer often shared with the adjacent digestive segment. DCs are most commonly located in the distal ileum; sometimes, they are associated with other visceral or skeletal anomalies. They are frequently discovered during childhood, following a bowel obstruction or abdominal pain. Here we report a rare case of an ileal DC lined by a pseudostratified and ciliated epithelium, discovered in an adult patient following intestinal obstruction syndrome.
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Affiliation(s)
- Nadir Miry
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Nassira Karich
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Mohammed Bakhti
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
| | - Tarik Deflaoui
- Department of Visceral Surgery and Digestive Oncology, Mohammed VI University Hospital, Oujda, MAR
| | - Amal Bennani
- Department of Pathology, Mohammed VI University Hospital, Oujda, MAR
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Siragusa L, Pathirannehalage Don C, Benavoli D, Diacinti D, Manenti G, Pocci M, Palmieri G, Rossi P. Completely Isolated Enteric Duplication Cyst and Incidental Neuroendocrine Tumor of the Appendix: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e923988. [PMID: 32829376 PMCID: PMC7467633 DOI: 10.12659/ajcr.923988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Patient: Female, 26-year-old Final Diagnosis: Completely isolated enteric duplication cyst and appendiceal neuroendocrine tumor Symptoms: Dysmenorrhea Medication: — Clinical Procedure: — Specialty: Oncology • Surgery
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Affiliation(s)
- Leandro Siragusa
- Department of Surgery, Tor Vergata University of Rome, Rome, Italy
| | | | | | - Davide Diacinti
- Department of Radiology, Tor Vergata University of Rome, Rome, Italy
| | - Guglielmo Manenti
- Department of Radiology, Tor Vergata University of Rome, Rome, Italy
| | - Marco Pocci
- Histopathologic Unit, Tor Vergata University of Rome, Rome, Italy
| | | | - Piero Rossi
- Department of Surgery, Tor Vergata University of Rome, Rome, Italy
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Deng Y, Hu Z, Liao J, Hao W, Hu G. Isolated retroperitoneal enteric duplication cyst associated with an accessory pancreatic lobe. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:3089-3095. [PMID: 31934150 PMCID: PMC6949690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 06/24/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Enteric duplication cysts are rare congenital anomalies. They are lined by gastrointestinal mucosa, connected to the digestive tract, and share smooth muscle layers and a common blood supply. In rare cases, duplication cysts are isolated from the digestive tract and have a unique blood supply. No patient with isolated duplication cysts that are located in the retroperitoneum and associated with an accessory pancreatic lobe at the onset have been reported to date. MATERIALS AND METHODS A 10-year-old Asian boy complained of left upper abdominal pain for more than 3 months. Contrast-enhanced computed tomography showed that the main pancreatic duct in the tail of the pancreas was dilated. A soft tissue density shadow was observed around the tail of the pancreas. The lesion was connected to the main pancreatic duct and the blood was supplied from a branch of the splenic artery. Surgical exploration and pathologic specimens resulted in the diagnosis of an isolated retroperitoneal enteric duplication cyst associated with an accessory pancreatic lobe. The patient received treatments of rehydration, antibiotics, and protease inhibitors. Due to the poor conservative treatment effect in internal medicine, a surgical resection of abnormal tissue was performed. RESULTS The boy did not have abdominal pain again in the first year after leaving the hospital. DISCUSSION For repeated abdominal pain in young people, especially in children, an enteric duplication cyst needs to be ruled out. This case was difficult to diagnose and imaging examination was not able to determine whether it is located in the anterior peritoneum or the retroperitoneum. For such cases, surgical exploration is necessary, and surgical resection can achieve more satisfactory results.
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Affiliation(s)
- Youyuan Deng
- Department of General Surgery, Institute of Digestive Surgery of Changsha, Affiliated Changsha Hospital of Hunan Normal UniversityChangsha 410006, Hunan, P. R. China
| | - Zhiya Hu
- Department of General Surgery, The Third Hospital of ChangshaChangsha 410015, Hunan, P. R. China
| | - Jie Liao
- Department of General Surgery, Institute of Digestive Surgery of Changsha, Affiliated Changsha Hospital of Hunan Normal UniversityChangsha 410006, Hunan, P. R. China
| | - Wenjie Hao
- Department of General Surgery, Institute of Digestive Surgery of Changsha, Affiliated Changsha Hospital of Hunan Normal UniversityChangsha 410006, Hunan, P. R. China
| | - Guohuang Hu
- Department of General Surgery, Institute of Digestive Surgery of Changsha, Affiliated Changsha Hospital of Hunan Normal UniversityChangsha 410006, Hunan, P. R. China
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KarthiKeyan M, SoundaraRajan L, Karthi M, UmaMaheswaran M, Rajendran S. Type B choledochocele vs duodenal duplication cyst: a diagnostic dilemma and its management: a case report. J Med Case Rep 2019; 13:160. [PMID: 31122272 PMCID: PMC6533763 DOI: 10.1186/s13256-019-2010-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 02/06/2019] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Duplication cyst of the alimentary tract is a rare congenital anomaly. Duodenal duplication cyst accounts for less than 5% overall. These entities rarely present in adults. They are often mistaken as choledochoceles. Management is most often complete excision, but it is individualized to the particular case. CASE PRESENTATION A 22-year-old woman was admitted to our hospital with a history of intermittent colicky right hypochondrial pain not relieved by any medications for the past 3 months. Initially, she was given proton pump inhibitors, but her pain was not relieved. Further evaluation was done, and preoperative imaging showed a cyst in the second part of the duodenum. Magnetic resonance imaging revealed it as a choledochocele, but duodenal duplication cyst was kept in the differential diagnosis. Further ultrasound identified it to be a duplication cyst. After failed endotreatment, the patient was successfully managed with partial excision and marsupialization. CONCLUSION Duodenal duplication cyst is uncommon and rarely diagnosed in adults. Duplications in the duodenum should always be a part of the differential diagnosis, especially in cystic lesions. Ultrasonogram of the cyst might lead to the proper diagnosis. Surgery is the treatment of choice if endotherapy is not successful.
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Affiliation(s)
- M KarthiKeyan
- Institute of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, India.
| | - L SoundaraRajan
- Institute of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, India
| | - M Karthi
- Institute of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, India
| | - M UmaMaheswaran
- Institute of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, India
| | - S Rajendran
- Institute of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, India
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Nakashima S, Yamada T, Sato G, Sakai T, Chinen Y, Itakura H, Kato R, Ueda M, Tsuda Y, Ohta K, Matsuyama J, Ikenaga M. A case of completely isolated advanced enteric duplication cyst cancer performed partial pancreatectomy. Int J Surg Case Rep 2018; 54:83-86. [PMID: 30553095 PMCID: PMC6297057 DOI: 10.1016/j.ijscr.2018.11.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/22/2018] [Accepted: 11/25/2018] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Enteric duplication cysts are rare and, in addition, isolated enteric duplication cysts are lower morbidity prevalence rate. These cysts lack a connection to the gastrointestinal tract or the adjacent mesenteric vasculature and have only been reported in 10 case reports. In these reports, only two reports were cases with malignant transformation. Our case was a report for the advanced cancer of the isolated enteric duplication cyst. CASE PRESENTATION The patient was a 43 year-old woman with slightly abdominal pain and mass formation. The abdominal contrast-enhanced computed tomography showed 130 × 100 × 90 mm huge cystic mass existed in right upper peritoneal cavity. The cystic mass had thickened wall and many enhanced nodules. As these imaging findings suggested a tumor originated from pancreas and the preoperative diagnose was suspect of mucinous cystic neoplasm. In operative findings, the tumor originated from pancreatic head and did not attach to gastrointestinal tract. Final pathology indicated the cyst was an isolated advanced enteric duplication cyst cancer and not originated from pancreas. CONCLUSION We experienced an extremely rare case of completely isolated advanced enteric duplication cyst cancer. Unique to this case, the preoperative diagnosis was suspect of mucinous cystic neoplasm arising from pancreas head and partial pancreatectomy was performed. However, in the pathological findings, this cyst diagnosed advanced enteric duplication cyst cancer.
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Affiliation(s)
- Shinsuke Nakashima
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Terumasa Yamada
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan.
| | - Go Sato
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Takaaki Sakai
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Yoshinao Chinen
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Hiroaki Itakura
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Ryo Kato
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Masami Ueda
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Yujiro Tsuda
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Katsuya Ohta
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Jin Matsuyama
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
| | - Masakazu Ikenaga
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 567-8588, Japan
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Elhasan MEAB, Sirdab YA, Bakheit IA. 54-cm enteric duplication cyst in a 13-year-old female. Clin Case Rep 2018; 6:2099-2102. [PMID: 30455900 PMCID: PMC6230635 DOI: 10.1002/ccr3.1751] [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: 12/15/2017] [Revised: 06/08/2018] [Accepted: 07/09/2018] [Indexed: 11/11/2022] Open
Abstract
Enteric duplication cyst is a very rare condition, the affected individual may be asymptomatic. It has serious complications, on top of which is a malignant transformation tendency. To avoid these complications, resection of the duplication seems to be mandatory, even if it is an incidental finding.
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Affiliation(s)
- Mohamed Elghazali Ahmed Basheer Elhasan
- Assistant Professor of General SurgeryIbrahim Malik Teaching HospitalFaculty of Medicine‐University of KhartoumSudan
- MSc‐anatomy MRCS ‐part A‐ (Ed)General Surgery ResidentSudan Medical Specialization Board (SMSB)Khartoum StreetKhartoumSudan
| | - Younis A. Sirdab
- Assistant Professor of General SurgeryIbrahim Malik Teaching HospitalFaculty of Medicine‐University of KhartoumSudan
| | - Imad A. Bakheit
- FRCS (Ireland)Assistant Professor of General SurgeryFaculty of MedicineUniversity of KhartoumSudan
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Weitman E, Al Diffalha S, Centeno B, Hodul P. An isolated intestinal duplication cyst masquerading as a mucinous cystic neoplasm of the pancreas: A case report and review of the literature. Int J Surg Case Rep 2017; 39:208-211. [PMID: 28854411 PMCID: PMC5575442 DOI: 10.1016/j.ijscr.2017.08.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 08/09/2017] [Accepted: 08/09/2017] [Indexed: 12/29/2022] Open
Abstract
Intestinal duplications cysts are rare congenital anomalies that can occur throughout the gastrointestinal tract. Isolated intestinal duplication cysts can present with vague abdominal complaints. Diagnosis can be challenging even with imaging. Our clinical workup was suggestive of a mucinous cystic neoplasm (MCN) of the pancreas. This represents the first reported case of an enteric duplication cyst that mimicked an MCN of the pancreas.
Introduction Enteric duplication cysts presenting in adulthood are rare. Isolated enteric duplication cysts, which lack a connection to the GI tract or the adjacent mesenteric vasculature, have only been cited in six previous case reports. Case presentation A 48-year-old female presented with a four-year history of intermittent nausea, vomiting and abdominal pain. Computed tomography (CT) scan of the abdomen revealed a 7 cm multi-lobular, calcified, cystic lesion intimately involved with the pancreas. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) was non-diagnostic; however, the cyst fluid Carcinoembryonic Antigen (CEA) level was significantly elevated leading to a presumed diagnosis of a mucinous cystic neoplasm (MCN) of the pancreas. Intraoperatively, the cystic mass was identified and notably did not have any true attachments to the neighboring pancreas, gastrointestinal tract or vasculature. Final pathology demonstrated an isolated small bowel duplication cyst. Discussion In this case a patient presented with a clinical picture consistent with an MCN of the pancreas. However, intraoperatively and on final pathology the mass was found to be an isolated enteric duplication cyst. This represents only the seventh such case report in an adult. Conclusion Although rare, isolated enteric duplication cysts can be considered in a patient presenting with chronic abdominal pain and an abdominal mass on imaging. In this case we demonstrate that an isolated enteric duplication cyst can clinically mimic an MCN of the pancreas.
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Abstract
The small intestine is a complex organ system that is vital to the life of the individual. There are a number of congenital anomalies that occur and present most commonly in infancy; however, some may not present until adulthood. Most congenital anomalies of the small intestine will present with obstructive symptoms while some may present with vomiting, abdominal pain, and/or gastrointestinal bleeding. Various radiologic procedures can aid in the diagnosis of these lesions that vary depending on the particular anomaly. Definitive therapy for these congenial anomalies is surgical, and in some cases, surgery needs to be performed urgently. The overall prognosis of congenital anomalies of the small intestine is very good and has improved with improved medical management and the advent of newer surgical modalities. The congenital anomalies of the small intestine reviewed in this article include malrotation, Meckel's diverticulum, duodenal web, duodenal atresia, jejunoileal atresia, and duplications.
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Affiliation(s)
- Grant Morris
- Department of Pediatrics, Geisinger Clinic, 100 N. Academy Avenue, Danville, PA, 17822, USA
| | - Alfred Kennedy
- Department of Pediatric Surgery, Geisinger Clinic, 100 N. Academy Avenue, Danville, PA, 17822, USA
| | - William Cochran
- Department of Pediatric Gastroenterology, Geisinger Clinic, 100 N. Academy Avenue, Danville, PA, 17822, USA.
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Yan X, Fan Y, Wang K, Zhang W, Song Y. Duodenal duplication manifested by abdominal pain and bowl obstruction in an adolescent: a case report. Int J Clin Exp Med 2015; 8:21710-21714. [PMID: 26885132 PMCID: PMC4723977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 09/02/2015] [Indexed: 06/05/2023]
Abstract
Duodenal duplication (DD) is a rare congenital anomaly reported mainly in infancy and childhood, but seldom in adolescent and adults. Symptoms, such as abdominal pain, nausea, vomiting or dyspepsia may present depending on the location and type of the lesion. DD can result in several complications, including pancreatitis, bowl obstruction, gastrointestinal bleeding, perforation and jaundice. Surgery is still the optimal method for treatment, although endoscopic fenestration has been described recently. Here, we report a case of a DD on the second portion of the duodenum in a 17-year-old adolescent complaining of transient epigastric pain and vomiting after meal. We suspected the diagnosis of DD by abdominal computerized tomography and endoscopic ultrasonography. We treated her by subtotal excision and internal derivation. Eventually, we confirmed our diagnosis with histopathological result.
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Affiliation(s)
- Xiaoyu Yan
- Department of The Second General Surgery, Shengjing Hospital of China Medical University Shenyang, Liaoning Province, People's Republic of China
| | - Ying Fan
- Department of The Second General Surgery, Shengjing Hospital of China Medical University Shenyang, Liaoning Province, People's Republic of China
| | - Kai Wang
- Department of The Second General Surgery, Shengjing Hospital of China Medical University Shenyang, Liaoning Province, People's Republic of China
| | - Wei Zhang
- Department of The Second General Surgery, Shengjing Hospital of China Medical University Shenyang, Liaoning Province, People's Republic of China
| | - Yanglin Song
- Department of The Second General Surgery, Shengjing Hospital of China Medical University Shenyang, Liaoning Province, People's Republic of China
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Župančić B, Gliha A, Fuenzalida JV, Višnjić S. Duodenal Duplication Cyst: A Rare Differential Diagnosis in a Neonate with Bilious Vomiting. European J Pediatr Surg Rep 2015; 3:82-4. [PMID: 26788454 PMCID: PMC4712054 DOI: 10.1055/s-0035-1558827] [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: 12/08/2014] [Accepted: 05/31/2015] [Indexed: 01/06/2023] Open
Abstract
Bilious vomiting is a relevant sign in neonates that requires immediate evaluation and diagnosis. A duplication of the intestinal tract is a possible cause of obstruction if located distally to the major duodenal papilla of Vater and most of them involve the jejunum, stomach, or colon. Duodenal duplications are very rare and can have an endoscopic or surgical treatment after diagnosis. We present a case of a 16-day-old term newborn that consulted because of bilious vomiting and after evaluation with imaging and upper endoscopy, a duodenal duplication cyst was found at the level of the third portion causing compression of the intestinal lumen that required surgical resolution with duodenocystostomy.
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Affiliation(s)
- Božidar Župančić
- Department of Pediatric Surgery, Zagreb Children's Hospital, Zagreb, Croatia
| | - Andro Gliha
- Department of Pediatric Surgery, Zagreb Children's Hospital, Zagreb, Croatia
| | | | - Stjepan Višnjić
- Department of Pediatric Surgery, Zagreb Children's Hospital, Zagreb, Croatia
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