Enteric duplication cysts in children: Are their ultrasonographic wall characteristics diagnostic?

Barr, Lori L.; Hayden, C. K.; Stansberry, S. D.; Swischuk, L. E.

doi:10.1007/bf02013165

Cited by 136 publications

(56 citation statements)

References 3 publications

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“…The presence of a double wall or muscular rim is well described in the literature, which refers to the appearance of a cyst mimicking the gastrointestinal tract with a hypoechoic rim of tissue representing the smooth muscle layer and an echogenic inner margin corresponding to the mucosa (11). Identification of this trait on an US of an abdominal mass has been regarded as characteristic of an enteric duplication cyst (12,13).…”

Section: Discussionmentioning

confidence: 99%

An ileal duplication cyst manifested as an ileocolic intussusception in an adult

Kim¹,

Sung²,

Park³

et al. 2015

Turk J Gastroenterol

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An enteric duplication cyst presenting as enterocolic intussusception is an exceptional clinical entity. We herein report a rare case of an ileal duplication cyst that manifested as an ileocolic intussusception. A 19-year-old woman was hospitalized due to right upper quadrant pain. Colonoscopy revealed a polypoid mass protruding into the colonic lumen. Ultrasonography demonstrated intussusception with a teardrop-shaped cystic mass at the tip. Computed tomography also showed ileocolic intussusception with a 2.5 cm-sized round cystic mass at the tip of intussusceptum. Microscopically, the cystic wall consisted of a well-defined smooth muscle coat and heterotopic gastric mucosa, consistent with an enteric duplication cyst. This case highlights an ileal duplication cyst as an uncommon cause of adult ileocolic intussusception. To the best of our knowledge, this is the first case of enteric duplication cyst identified as a pathological lead point for enterocolic intussusception in an adult. Enteric duplication cysts should be included in the differential diagnosis of cystic-leading lesions for adult intussusceptions. Keywords: Enteric duplication cyst, enterocolic intussusception, adult INTRODUCTIONIntussusception occurs when a portion of the digestive tract becomes telescoped into the adjacent bowel segment. This condition usually occurs in children between 6 months and 2 years of age. In the past, intussusception was a severe condition with high morbidity and mortality rates. Currently, prompt diagnosis and effective treatment lead to a favorable outcome in most cases. Enteric duplication cysts are an uncommon congenital abnormality that manifest before 2 years of age in 80% of cases and that can occur anywhere along the gastrointestinal tract on the mesenteric side. The presenting signs and symptoms of enteric duplication cysts include abdominal distension, vomiting, bleeding, a palpable abdominal mass and urinary infrequency. The clinical manifestations are usually intestinal obstruction from adjacent pressure, volvulus and rarely intussusception (1). A thorough review of the literature revealed a few case reports of enteric duplication cysts causing enterocolic intussusception in infants (2-5); however, no such cases have been reported in adults to the best of our knowledge. We herein report a rare case of an ileal duplication cyst manifested as an ileocolic intussusception in a young adult woman. CASE PRESENTATIONA 19-year-old woman without medical or surgical history was hospitalized due to right upper quadrant pain. Physical examination revealed a tender palpable mass in the right upper quadrant of the abdomen. Laboratory results were within the normal range. Colonoscopy revealed a polypoid mass protruding into the colonic lumen ( Figure 1a). Ultrasonography (US) showed intussusception with a teardrop-shaped cystic mass at the tip, which had a double-layered wall consisting of a hypoechoic outer layer and an echogenic inner layer (Figure 1b). Computed tomography (CT) demonstrated ileocolic intussuscept...

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Section: Discussionmentioning

confidence: 99%

An ileal duplication cyst manifested as an ileocolic intussusception in an adult

Kim¹,

Sung²,

Park³

et al. 2015

Turk J Gastroenterol

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“…Duodenal duplication is differentiated from other cystic lesions by the "gut signature" of its wall observed by abdominal or endoscopic US. Gut signature refers to the layered pattern of the wall, with the hyperechoic inner layer representing the submucosa and the hypoechoic outer layer representing the smooth muscle [8][9][10] . Peristalsis of the cyst wall noted upon real-time US is strongly suggestive of a duplication cyst [11] .…”

Section: Discussionmentioning

confidence: 99%

A rare case of duodenal duplication treated surgically

Uzun

Köksal²,

Kayahan³

et al. 2009

WJG

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Duodenal duplication, a rare congenital malformation, can also be observed in adulthood. Although it can be cystic or tubular, communicating or noncommunicating, cystic and non-communicating forms are the most common. Several complications, such as obstruction, bleeding, perforation and pancreatitis, may result. Optimal treatment is total excision, although endoscopic procedures have also been described in appropriate cases. If total excision is not possible, subtotal excision and internal derivation can be performed. The 38-year-old woman presented here had occasional attacks of abdominal pain and obstruction, and we considered the diagnosis of duodenal duplication by abdominal computerized tomography. As we confirmed the diagnosis with operative findings and histopathological signs, we treated her with subtotal excision and intraduodenal cystoduodenostomy.

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“…At US, duplication cysts demonstrate an echogenic inner mucosal layer and a hypoechoic outer muscular layer (Fig 8). This appearance is usually not circumferential, as the layers are often nonuniform in thickness, but this double-layered wall is often found in over 50% of cases (6). A barium study such as an upper gastrointestinal series with small bowel follow-through or a barium enema examination may demonstrate a submucosal mass with mass effect extending into the lumen of the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%