Duodenal duplication cyst identified with MRCP

Carbognin, Giovanni; Guarise, Alessandro; Biasiutti, Carlo; Pagnotta, Nicoletta; Procacci, Carlo

doi:10.1007/s003309900286

Cited by 8 publications

(4 citation statements)

References 7 publications

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“… 13 Magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP) can also be used diagnostically, and to exclude cyst communication with the pancreaticobiliary ducts. 4 , 16 , 28 , 29 If the choledochus drains into the DDC, only the pancreatic duct fills with contrast during ERCP. 16 A meta-analysis revealed false negative rates for DDC of 23% with US and 9% with CT or MRI/MRCP.…”

Section: Resultsmentioning

confidence: 99%

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Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts

et al. 2016

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Analyze efficacy, safety of endoscopic therapy for duodenal duplication cysts (DDC) by comprehensively reviewing case reports.Tandem, independent, systematic, computerized, literature searches were performed via PubMed using medical subject headings or Keywords “cyst” and “duodenal” and “duplication”; or “cyst”, and “endoscopy” or “endoscopic”, and “therapy” or “decompression”; with reconciliation of generated references by two experts. Case report followed CARE guidelines.Literature review revealed 28 cases (mean = 1.3 ± 1.2 cases/report). Endoscopic therapy is increasingly reported recently (1984–1999: 3 cases, 2000–2015: 25 cases, P = 0.003, OR = 8.33, 95%-CI: 1.77–44.5). Fourteen (54%) of 26 patients were men (unknown-sex = 2). Mean age = 32.2 ± 18.3 years old. Procedure indications: acute pancreatitis-16, abdominal pain-8, jaundice-2, gastrointestinal (GI) obstruction-1, asymptomatic cyst-1. Mean maximal DDC dimension = 3.20 ± 1.53 cm (range, 1–6.5 cm). Endoscopic techniques included cyst puncture via needle knife papillotomy (NKP)/papillotome-18, snare resection of cyst-7, cystotome-2, and cyst needle aspiration/ligation-1. Endoscopic therapy was successful in all cases. Among 24 initially symptomatic patients, all remained asymptomatic post-therapy without relapses (mean follow-up = 36.5 ± 48.6 months, 3 others reported asymptomatic at follow-up of unknown duration; 1 initially asymptomatic patient remained asymptomatic 3 years post-therapy). Two complications occurred: mild intraprocedural duodenal bleeding related to NKP and treated locally endoscopically.A patient is reported who presented with vomiting, 15-kg-weight-loss, and profound dehydration for 1 month from extrinsic compression of duodenum by 14 × 6 cm DDC, underwent successful endosonographic cyst decompression with large fenestration of cyst and endoscopic aspiration of 1 L of fluid from cyst with rapid relief of symptoms. At endoscopy the DDC was intubated and visualized and random endoscopic mucosal biopsies were obtained to help exclude malignant or dysplastic DDC.Study limitations include retrospective literature review, potential reporting bias, limited patient number, variable follow-up.In conclusion, endoscopic therapy for DDC was efficacious in all 29 reported patients including current case, including patients presenting acutely with acute pancreatitis, or GI obstruction. Complications were rare and minor, suggesting that endoscopic therapy may be a useful alternative to surgery for nonmalignant DDC when performed by expert endoscopists.

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Section: Resultsmentioning

confidence: 99%

“…Definitive diagnosis requires EGD with endosonographic confirmation, or surgery with pathologic analysis of resected tissue. 22 , 29 , 31 – 34 At EGD, DDC appear as a duodenal bulge with normal overlying mucosa, or as a variably long diverticulum. DDC usually have a smooth, regular, mucosal appearance.…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts

et al. 2016

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“…Unlike duodenal duplication, they lack a smooth muscle layer [7]. Duodenal duplication cysts also have to be differentiated from other cystic masses belonging to the duodenalcholedochal-pancreatic area (ie, cystic dystrophy of the duodenal wall, pseudocyst of the pancreas, cystic tumors of the pancreas, cystic lymphatic malformation, and mesenteric cyst) [2,22,25,34,36].…”

Section: Discussionmentioning

confidence: 98%

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

Chen¹,

Lee²,

Yeung³

et al. 2010

Journal of Pediatric Surgery

117

140

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“…Contrast enhanced CT provides an accurate definition of the cyst and its relations [2,21]. Magnetic resonance imaging [22] and magnetic resonance cholangiopancreatography [23] have also been utilised.…”

Section: Discussionmentioning

confidence: 99%

Duodenal duplication cyst: beware of the lesser sac collection

Cauchi

Buick

2006

Ped Surgery Int

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A 11-month-old boy presented with a 4-month history of failure to thrive. His initial presentation was highlighted by fever, postprandial abdominal pain and lethargy. The diagnosis was elusive despite extensive investigations. A contrast enhanced abdominal computerised tomogram (CT) suggested the presence of a pancreatic pseudocyst. At laparotomy, a lesser sac collection was drained and the patient's general condition improved. Three weeks postoperatively, the symptoms recurred and a second contrast enhanced abdominal CT revealed a duodenal duplication cyst. A 6.5-cm duodenal duplication cyst communicating with the fourth part of the duodenum was resected in its entirety with resolution of the patients' symptoms and establishment of adequate growth.

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Duodenal duplication cyst identified with MRCP

Cited by 8 publications

References 7 publications

Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts

Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts

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

Duodenal duplication cyst: beware of the lesser sac collection

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