A Gastric Duplication Cyst with an Aberrant Pancreatic Ductal System: Report of a Case

Abstract

We report an extremely rare case of a gastric duplication cyst together with an aberrant pancreatic ductal system, which communicated with the stomach rather than the pancreatic ductal system with no evidence of pancreatitis. A 46-year-old woman developed severe abdominal pain after a 10-year history of occasional mild abdominal pain. Upper gastrointestinal barium radiography showed a rigidity of the stomach wall, and gastroscopy revealed a fistula orifice at a greater curvature of the gastric body. Subsequent endoscopic suction of mucous secretion from within the fistula provided immediate pain relief. Abdominal computed tomography and ultrasonography showed a cystic mass contiguous with the stomach wall. Surgical exploration revealed an uncommon anomaly of a gastric duplication cyst with the aberrant pancreatic lobe. The patient made an uneventful recovery and remains well 4 years after surgery. We also herein review ten other similar cases of this uncommon congenital anomaly reported in the literature.

Recurrent Acute Pancreatitis Caused by a Gastric Duplication Cyst Communicating with an Aberrant Pancreatic Duct

“…A gastric duplication cyst communicating with an aberrant pancreatic duct is rarer. Fifteen cases (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) have been reported, and several cases with recurrent acute pancreatitis have also been reported (Table 1). It has been suggested that the underlying cause involves obstruction of the pancreatic duct by viscous mucus secretions, ulcer bleeding or biliary sludge.…”

An unusual cause of recurrent pancreatitis: A gastric duplication cyst with an accessory pancreatic lobe

“…In patients with gastric duplication cysts communicating with aberrant pancreatic duct, abdominal pain is often related to acute pancreatitis. Recurrent acute pancreatitis caused by this anomaly have been reported in 12 cases (66%) (4)(5)(6)(7)(8)(9)(11)(12)(13)(14)16,17). Oeda et al (17) reported that there were not significant differences between the patients with pancreatitis and without pancreatitis in terms of either sex or age.…”

“…In the patients with this anomaly, a definitive diagnosis was rarely made preoperatively and several operative explorations were required in some cases (11,12). The aberrant pancreatic ductal system was revealed by endoscopic retrograde cholangiopancreaticography (ERCP) in majority of the cases diagnosed preoperatively and the usefulness of ERCP was emphasized (6,13). To our knowledge, there are only a few reports of spiral computed tomography (CT) (13) and no previous report of multidetector CT and magnetic resonance imaging (MRI) findings of this unusual anomaly.…”

“…The accessory pancreatic lobe is an extremely rare congenital anomaly of the pancreas (6,(10)(11)(12)(13)16). This anomaly is defined as an accessory lobe of pancreatic tissue originating from the main pancreatic gland and it contained an aberrant duct.…”

“…A gastric duplication cyst communicating with an aberrant pancreatic duct is an extremely rare but curable cause of recurrent pancreatitis in children and young adults. Only 18 cases that have this unusual anomaly have been reported in the literature (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), and in minority of them an associated accessory pancreatic lobe was described (6,(10)(11)(12)(13)16). In the patients with this anomaly, a definitive diagnosis was rarely made preoperatively and several operative explorations were required in some cases (11,12).…”