Complete large bowel duplication with paraduodenal cyst: prenatal sonographic features

Abstract

Prenatal findings of a hugely dilated, hyperperistaltic large bowel should lead one to suspect/consider large bowel duplication. Associated cysts are likely to be bowel duplication cysts. Timely intervention can thus obviate potentially serious complications.

Meta-analysis: the clinical features of the duodenal duplication cyst

“…Two cases had a prenatal diagnosis made by ultrasound [19,22], whereas another 2 were asymptomatic and were incidental findings [4,16]. Ninetytwo percent of patients older than 10 years and 57% of patients younger than 10 years complained of abdominal pain (P = .009), whereas 28% of patients older than 10 years and 63% of patients from newborn to 10 years old presented with nausea and/or vomiting (P = .019).…”

“…The age of presentation ranged from newborn [19,22] to 72 years [14]. Even if one patient's sex was unknown [22], there was no sex predominance as males and females had a 1:1 ratio of cases (n = 23 each). The case number decreased as age increased (Fig.…”

“…On ultrasonography, duodenal duplication is seen as an anechoic, double-walled, bilobed cystic lesion containing debris in the pyloroduodenal region, or sometimes, as an echogenic mass [9,22]. It may have muscular peristalsis, which helps distinguish duplication cysts from other abdominal cysts [8].…”

“…Grossly, most duodenal duplications are cystic and usually communicate with the pancreatic or biliary ducts. In contrast, some tubular duodenal duplications may communicate with the native duodenal lumen [22,32]. This review shows that 29% of duplication cysts connect to the pancreaticobiliary ducts and 2 cysts have aberrant ducts to the pancreatic head.…”

“…They may be lined with duodenal mucosa, ectopic gastric mucosa, pancreatic, or respiratory epithelium [22,25]. Grossly, most duodenal duplications are cystic and usually communicate with the pancreatic or biliary ducts.…”