Nowadays, the prognosis of apple-peel atresia depends mainly on prolonged TPN-related morbidity rather than immediate postoperative complications. We therefore recommend that those infants affected be managed by primary anastomosis in order to reduce the duration of parenteral nutrition, followed by careful nutrition by teams experienced in neonatal TPN and short bowel syndrome.
Gastric duplication cyst is uncommon congenital malformation rarely seen in the adult population. Although complications related to duplication such as infection, haemorrhage, obstruction, and fistula formation with neighbouring structures had been previously reported, fistulization into the colon in adult has been previously never described to our knowledge. In this study, we present the case of a 36‐year‐old male patient with moderate mental retardation who presented with 10 months history of progressive abdominal pain, nausea, vomiting, and important weight loss. Clinical assessment and radiological investigations demonstrated the presence of non‐communicating gastric duplication cyst inserted on the greater curvature of the antrum and fistulized into the transverse colon. At laparotomy, the cyst was completely excised and the colon containing the fistula was resected with colo‐colonic anastomosis. Pathology confirmed gastric duplication and demonstrated that the inner surface of the cyst was lined by gastric type mucosa. The patient had an uneventful recovery and after 3 months of follow‐up, all symptoms disappeared. Also, he gained 11 kg in weight. This case highlights, therefore, the fact that all gastric duplication cysts should be removed in order to avoid the risk of serious complications.
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