A report of two infant cases operated for jejunal duplication cyst associated with malrotation and volvulus

Azzam, Ahmed M.; Abdulkarim, Ali; Shehata, Ahmed; Mahran, Ibrahim; Arafa, Ahmed; Arafat, Ahmed; Tawfik, Sherifa; Shaban, Muayad; Anache, Aliyu; Kaddah, Sherif; Taher, Heba

doi:10.1016/j.ijscr.2020.02.009

Cited by 14 publications

(13 citation statements)

References 7 publications

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“…Three of the 15 neonates had multiple anomalies, including Meckel's diverticulum, congenital heart disease, gastrointestinal duplication cyst, and trisomy 21, similar to the results described by Kedoin ( 1 ), Shehata ( 29 ), and Azzam et al ( 31 ). Although coexisting intestinal malrotation and enteric duplication cyst or cardiac anomalies are rare, children with gut duplication or congenital heart problems should be aware of accompanying congenital malrotation ( 30 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

Identification and treatment of intestinal malrotation with midgut volvulus in childhood: a multicenter retrospective study

Yang,

Wang,

Wang

et al. 2024

Front. Pediatr.

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BackgroundIntestinal malrotation is a rare condition, and its delayed diagnosis can lead to fatal consequences. This study aimed to investigate the identification and treatment of malrotation in children.MethodsClinical data, imaging, operative findings, and early postoperative outcomes of 75 children with malrotation were retrospectively analyzed.ResultsThe mean age was 6.18 ± 4.93 days and 51.26 ± 70.13 months in the neonatal group (56 patients) and non-neonatal group (19 patients), respectively. Sixty-seven patients were under the age of 1 year at the time of diagnosis. The occurrence of bilious vomiting and jaundice was significantly higher in the neonatal group (89.29%) than that in the non-neonatal group (37.5%), p < 0.05 and p < 0.01, respectively. The incidence of abnormal ultrasound (US) findings was 97.30% and 100%, respectively, and the sensitivities of the upper gastrointestinal series were 84.21% and 87.5%, respectively. Sixty-six (88%) patients had midgut volvulus, including in utero volvulus (two patients) and irreversible intestinal ischemia (four patients). Most neonates (89.29%) underwent open Ladd's procedure with a shorter operative time (p < 0.01). Reoperation was performed for postoperative complications (four patients) or missed comorbidities (two patients).ConclusionsNon-bilious vomiting was the initial symptom in >10% of neonates and nearly 40% of non-neonates. This highlights the importance for emergency physicians and surgeons to be cautious about ruling out malrotation in patients with non-bilious vomiting. Utilizing US can obviate the need for contrast examinations owing to its higher diagnostic accuracy and rapid diagnosis and can be recommended as a first-line imaging technique. Additionally, open surgery is still an option for neonatal patients.

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Section: Discussionmentioning

confidence: 99%

Identification and treatment of intestinal malrotation with midgut volvulus in childhood: a multicenter retrospective study

Yang,

Wang,

Wang

et al. 2024

Front. Pediatr.

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“…And most of them are accidentally found during imaging examinations due to clinical symptoms such as abdominal pain, ileus, intussusception, hematochezia, and dyspnea etc. Simple multiple intestinal duplications are rarely reported separately ( 4 , 6 , 7 ). The incidence of multiple small intestinal duplications in intestinal duplication is approximately 5% and extremely rare ( 6 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…Surgery is the only effective treatment for small intestinal duplications. The preferred treatment is resection of the duplication together with the adjacent normal intestine, followed by primary anastomosis ( 3 , 4 ). The risk of intestinal fistula after multiple intestinal resections and intestinal anastomoses is relatively higher than that after a single intestinal anastomosis ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Case report: Ileocecal preservation for multiple small intestinal duplications

Liu

et al. 2023

Front. Pediatr.

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Small-intestinal duplication is a rare congenital developmental anomaly that is mainly single; multiple small-intestinal duplications are rare. Most malformations are located in the ileocecal region. The primary surgical treatment is complete resection of the malformations and adjacent intestinal ducts. However, the ileocecal junction plays an important role in children, and it is difficult to preserve it; multiple intestinal repairs increase the risk of postoperative intestinal fistula, which is a challenge for pediatric surgeons. Herein, we report a case of ileocecal preservation surgery for the treatment of multiple small intestinal duplication malformations near the ileocecal area. The child underwent laparoscopically assisted cyst excision and multiple intestinal repairs and had good postoperative recovery and follow-up.

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“…SIT is an anatomical variation caused by the clockwise rotation of the embryonic midgut ( 11 ). When the fetus’ intrauterine bowel fails to rotate 270° anti-clockwise back into the abdomen, it exposes the small bowel to volvulus and ischemia of the bowel, which is a grave condition that has to be operated within hours ( 12 ). All of the thoracic and abdominal visceral organ positions in people with SIT are located conversely compared with normal people, similar to a mirror image of normal people.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy for gastric cancer in a patient with situs inversus totalis: with video

Li,

Zhang,

Tian

et al. 2023

Front. Oncol.

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Because of its significant advantage of fast postoperative recovery, natural orifice specimen extraction surgery (NOSES) has attracted increasing attention worldwide. However, the NOSES in gastric cancer (GC) treatment still needs more clinical practice, especially for the rare anatomical anomaly. Situs inversus totalis (SIT) is a rare autosomal recessive anatomical anomaly with an incidence ranging between 1/8,000 and 1/25,000 births. We present a video of transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy performed in a 59-year-old woman known to have SIT. Preoperative investigations revealed that the patient had early GC at the antrum. A gastroscopy report from the local hospital showed signet-ring cell carcinoma. The preoperative computed tomography scan revealed irregular thickening of the gastric wall at the junction of the greater curvature and antrum without metastasis to the lymph nodes. In total, laparoscopic D2 distal gastrectomy was performed with transvaginal specimen extraction. Billroth II with Braun anastomosis was performed for reconstruction. The length of the operation was 240 min without intraoperative complications and with minimal blood loss of 50 ml. The patient was uneventfully discharged on postoperative Day 7. The final pathology confirmed signet-ring cell carcinoma confined to the mucosal muscle without metastasis in 16 lymph nodes. Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy can be safely performed in patients with SIT and has similar surgical outcomes to usual laparoscopic gastrectomy.

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A report of two infant cases operated for jejunal duplication cyst associated with malrotation and volvulus

Cited by 14 publications

References 7 publications

Identification and treatment of intestinal malrotation with midgut volvulus in childhood: a multicenter retrospective study

Identification and treatment of intestinal malrotation with midgut volvulus in childhood: a multicenter retrospective study

Case report: Ileocecal preservation for multiple small intestinal duplications

Case Report: Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy for gastric cancer in a patient with situs inversus totalis: with video

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