A rare case of acute abdomen in the adult: The intestinal duplication cyst. case report and review of the literature

Abstract

IntroductionDuplications of the gastrointestinal tract are rare congenital anomalies that can occur anywhere throughout the gastrointestinal tract. The reported incidence is 1/4500, and more than 80% occurs before the age of two as an acute abdomen or bowel obstruction. The most common site is Ileum (60%), while the colonic localisation is reported between 4 and 18%.Presentation of the caseHerein we report the case of a 35-year-old man, presented at the Emergency Department with fever and localised abdominal pain in the right iliac fossa. Preoperative abdominal ultrasound and CT scan showed a cystic mass of 44 × 43 × 70 mm adjoining the posterior wall of the right colon. He underwent explorative laparoscopy, laparotomy conversion, right hemicolectomy with an intra-operative diagnosis of colonic duplication cyst, confirmed by histology.DiscussionThe review of the literature showed as the intestinal duplication cysts are rare congenital anomalies. The clinical presentation is variable and depends on the site and the related complications. A surgical approach based on the resection of the involved bowel tract is the treatment associated with the best long-term outcomes.ConclusionIt is important to include intestinal duplication in the differential diagnosis of acute abdomen, to ensure the best therapeutic strategy.

Intussusception Caused by Cecal Duplication in an Adult: A Case Report

“…Appendiceal mucocele was also considered as an alternative diagnosis. Symptoms presented by the patient were initially sporadic and nonspecific, which is a usual observation for patients reaching adulthood with ‘silent' cyst [ 4 ]. The cystic lesion was stable over nine months.…”

A Rare Case of Cecal Duplication Cyst—a Case Report

“…They can present as vague abdominal pain, acute abdomen, or asymptomatic masses in adults. Gastric mucosa is found in about half the cases of GI duplication cysts thereby leading to ulceration which in turn may cause perforation and/or hemorrhage [4].…”

Incidental finding of jejunal duplication cyst during laparotomy: A case report

“…Duplications are most frequently single. They are located on the mesenteric border of the associated native bowel and vary in size and shape: cystic in 80% of cases and tubular in the remaining 20%, with or without other congenital anomalies [ 2 ].…”

“…Enteric duplication cysts is most frequently observed in the terminal part of the ileum [ 3 ]. More than 80% of the cases present before the age of 2 years as an acute abdomen or bowel obstruction, but many duplications remain silent unless complications occur, and therefore may not be diagnosed until adulthood [ 2 ]. Complications include volvulus, bleeding, and, rarely, malignant degeneration [ 4 ].…”