Experience with gastro-intestinal duplications in childhood

Schalamon, Johannes; Schleef, Jürgen; Höllwarth, Michael E.

doi:10.1007/s004230000170

Cited by 98 publications

(79 citation statements)

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“…The incidence of ED in our study was comparable to other reports in the literature. (5,8,17) None of our patients had heterotopic pancreatic mucosa, contrary to a report by Sato et alIn conclusion, ED should be considered in the differential diagnosis of patients with unexplained abdominal symptoms and bleeding per rectum. In patients who present with rectal bleeding, a radioactive imaging for Meckel's diverticulum could help to diagnose potential duplications with ectopic gastric mucosa.…”

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confidence: 77%

“…According to the literature, the ileum is the most common site of ED, whereas gastric and colonic duplications are rare, (4) and thoracoabdominal duplications are the most challenging. (7)(8)(9) In our series, the ileum was the most commonly involved site (n = 5), presenting as either an isolated lesion or a combination. However, contrary to the literature, which does not describe a high incidence of rectal involvement, (7,9,10) our series saw four cases (out of a total of nine) of rectal involvement.…”

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confidence: 76%

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Enteric duplication in children: clinical presentation and outcome

Rasool¹,

Safdar²,

Ahmad³

et al. 2013

smedj

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RESULTSOf the nine patients who presented with ED, nearly two-thirds were infants (age range 3 months-5 years). Seven (77.8%) were male and two (22.2%) were female. The presenting symptoms were varied, with the most common being abdominal mass and bleeding per rectum. Descriptions of the patients' age and gender, clinical features, main investigations, types and sites of cysts, surgical procedures performed and complications observed are RESULTS A total of nine patients were managed during the study period. The patients' ages ranged from three months to five years. Four out of nine EDs were rectal duplications. Three EDs were of the cystic type, five were of the tubular type and one was a complex mixed anomaly. Patients presented with varied symptoms, with the two most common being the presence of an abdominal mass and bleeding per rectum. Diagnosis was mainly achieved based on magnetic resonance imaging and computed tomography, although Meckel's scan provided accurate diagnosis in three of the nine patients. All the cysts were resected without any major complications, and patients were event-free during the five-year follow-up. Table I. A total of four out of nine patients had rectal duplications, and a perineal mass was noted in one (11.1%) patient. One patient had infected wound discharge following drainage of a perineal abscess, while penoscrotal hypospadias was present in another. (2) Although ED may present at any age, a majority are also why EDs may pose as a diagnostic challenge. In the present study, none of the patients were diagnosed antenatally. CONCLUSIONSome patients, however, had unusual symptoms -one patient presented with a nonhealing wound in the perineum that had previously been incised and drained due to suspicions of it being a perineal abscess, although a closer look at the surface would have revealed the presence of mucosa in the deeper part of the wound. Only one patient in our series had associated penoscrotal hypospadias. Such anomalies have been reported in up to 50% of patients, with vertebral defects being the most common.(1)EDs may be cystic, tubular or mixed (cystic and/or tubular).Although EDs usually communicate with adjacent parts of the gut, instances of completely isolated duplication cysts have also been reported. (6) We found various types of duplication cysts in our patients, including the cystic, tubular and complex mixed varieties. According to the literature, the ileum is the most common site of ED, whereas gastric and colonic duplications are rare, (4) and thoracoabdominal duplications are the most challenging. (7)(8)(9) In our series, the ileum was the most commonly involved site (n = 5), presenting as either an isolated lesion or a combination. However, contrary to the literature, which does not describe a high incidence of rectal involvement, (7,9,10) our series saw four cases (out of a total of nine) of rectal involvement. Also, there was a higher incidence of tubular ED (n = 5) in our study. Interestingly, one patient had a rare, complex duplication cyst that s...

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confidence: 77%

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confidence: 76%

Enteric duplication in children: clinical presentation and outcome

Rasool¹,

Safdar²,

Ahmad³

et al. 2013

smedj

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“…2 El término de "duplicación intestinal quística" fue acuñado por Fitz (1884) y Ladd (1937). 3 Las duplicaciones pueden localizarse en cualquier punto del tubo digestivo y son más habituales en el íleon terminal y el duodeno, e infrecuentes en el colon y el estómago.…”

Section: Discussionunclassified

Duplicación quística intestinal. Caso clínico

et al. 2017

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Presentación de casos clínicos RESUMENLas duplicaciones intestinales quísticas son anomalías congénitas infrecuentes, con incidencia de 1:4500 autopsias y etiopatogenia incierta. Son estructuras quísticas, tubulares o diverticulares revestidas de mucosa gastrointestinal con pared de músculo liso, adheridas al tracto gastrointestinal, pero no suelen comunicar con la luz intestinal. Los quistes de duplicación gástrica representan el 7-9% de los quistes de duplicación intestinal. Pueden diagnosticarse intraútero mediante ecografía y la resonancia magnética fetal permite caracterizar el quiste y descartar patologías concomitantes. La ecografía posnatal revela una imagen quística de "doble pared". Los neonatos suelen permanecer asintomáticos, pero pueden presentar desde síntomas gastrointestinales inespecíficos hasta síntomas de obstrucción por efecto masa, torsión o infección. En pacientes asintomáticos, se aconseja el seguimiento clínico y estudios de imagen periódicos. El tratamiento es la resección quirúrgica electiva, de manera preferente, con técnicas mínimamente invasivas. Se presenta un caso con sospecha prenatal de quiste de duplicación enteral. Palabras clave: recién nacido, anomalías congénitas, anomalías del sistema digestivo, quistes, ultrasonografía fetal. ABSTRACTIntestinal cystic duplications are rare congenital anomalies, with an estimated incidence of approximately 1:4500 autopsies. The etiopathogenesis is uncertain. These duplications are cystic, tubular or diverticular structures lined with gastrointestinal mucosa. They share a common smooth muscle wall with the gastrointestinal tract but usually their lumens do not communicate with each other. Gastric duplication cysts represent 7-9% of the gastrointestinal tract duplication. They can be diagnosed prenatally by fetal ultrasound; magnetic resonance imaging characterizes the cyst and excludes other malformations. Postnatal ultrasound shows a characteristic double walled cyst. Newborns are usually asymptomatic, although nonspecific gastrointestinal symptoms, intestinal obstruction due to mass effect, volvulus or infection are described. In asymptomatic patients, clinical follow-up and Duplicación quística intestinal. Caso clínicoIntestinal cystic duplication. Case report periodic image controls are recommended. Elective surgical resection is the treatment of choice, using minimally invasive technique whenever possible. A case of prenatally suspected intestinal cystic duplication is presented.

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“…These congenital abnormalities of the GI tract are rare and their incidence is reported to be 1:4,500 [2]. Duplication of the GI tract can happen anywhere from the tongue to the anus.…”

Section: Introductionmentioning

confidence: 99%

Rare Case of Duplication Cyst was Misdiagnosed as Pancreatic Pseudocyst

Absah

2013

J Med Cases

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A 7-year-old boy presents with a history of recurrent pancreatitis. His abdominal pain started in 2007, but his first episode of pancreatitis was in January 2010. Since that time has had at least five known episodes of pancreatitis with mild elevation of his amylase and lipase (range: 200 -300). There is no history of abdominal trauma and he had negative genetic testing for the hereditary pancreatitis (CFTR, PRSS1, and SPINK1 gene mutations). He had numerous imaging studies revealing a persistent cystic lesion near the pancreatic head, since his first episode of pancreatitis. Computed tomography of the abdomen showed thick-walled U-shaped cystic structure lying between the head of the pancreas, the inferior gastric antrum and the proximal descending duodenum. An abdominal US demonstrated a bi-lobed thick-walled cystic mass with a positive rim sign. Recurrent pancreatitis is uncommon in pediatric patients. Causes of recurrent pancreatitis in pediatrics are different than those in adults. While hereditary pancreatitis is one of the causes, the genetic testing was negative and there was no sign of pancreatic injury or inflammation in any of the images. Pancreatic pseudocyst is a complication of acute pancreatitis and usually has a thin wall instead of a thick wall, and it's unlikely to be present during the first episode of pancreatitis. Foregut duplication cyst is a rare (about 1 in 4,500) congenital anomaly that can happen anywhere throughout the GI tract. The US finding of a rim sign is a typical appearance of a duplication cyst and usually is managed by surgical resection. Even though foregut duplication is a rare congenital anomaly, it should always be considered in the differential diagnosis of cases of chronic pancreatis, especially with the presence of thick walled cystic formation on imaging studies.

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Experience with gastro-intestinal duplications in childhood

Cited by 98 publications

References 16 publications

Enteric duplication in children: clinical presentation and outcome

Enteric duplication in children: clinical presentation and outcome

Duplicación quística intestinal. Caso clínico

Rare Case of Duplication Cyst was Misdiagnosed as Pancreatic Pseudocyst

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