Alimentary Tract Duplication in Pediatric Patients: Its Distinct Clinical Features and Managements

Abstract

Purpose: Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. Methods: We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. Results: A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). Conclusion: ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.

Colonic Duplication Cyst with Gastric and Pancreatic Heterotopia: A Case Report

“…Presentations can also include gastrointestinal bleeding, intussusception, or as an incidental finding (Table 1). This may depend on the size, location, type, and presence of ectopic mucosa (6). In our case, this was an incidental finding during exploratory laparotomy.…”

“…We should keep in mind the potential for malignant change in patients whose duplications are detected in old age. Although the etiology is currently unknown, duplications are believed to occur between the 4th and 8th weeks of embryological development (6). The ileum is the most common site for a duplication cyst (30-35%), while the colon is the least common site (7-20%).…”

Duplication of the Small Intestine in Emergency Pediatric Surgery

“…Відсутність специфічних симптомів та візуальних проявів подвоєння шлунково-кишкового тракту (ШКТ) обумовлює значні труднощі у визначенні діагнозу, показів до хірургічного лікування, що може бути причиною як гіпо-так і гіпердіагностики, виникнення ускладнень [1][2][3]. Так, однією із найбільш поширених скарг у дитячому віці, є абдомінальний біль, який слід диференціювати за належністю до функціонального або одного із симптомів, притаманних гострій хірургічній патології [4,5].…”

Neonate with congenital pulmonary airway malformation concurrent with enteric duplication cyst: a case report of a rare anomaly

“…Enteric duplication cysts are congenital cystic or tubular structures attached to a portion of the alimentary tract with an incidence of 1 in 4500 births [ 3 ]. They most commonly occur in the midgut, particularly the ileocecal region, but may be located anywhere in the gastrointestinal tract [ 3 ].…”

“…Enteric duplication cysts are congenital cystic or tubular structures attached to a portion of the alimentary tract with an incidence of 1 in 4500 births [ 3 ]. They most commonly occur in the midgut, particularly the ileocecal region, but may be located anywhere in the gastrointestinal tract [ 3 ]. While these congenital abnormalities have been well-described individually, their coexistence is rare, with no established management guidelines.…”