Foreign Body in Duodenum Mimicking a Duplication Cyst on Imaging

Abstract

Paediatric age group is most vulnerable for the accidental foreign body (FB) ingestion which may go unnoticed. These patients present with symptoms or complications as a result of FB and may mimic other conditions on various investigations. We describe a 9-month old infant who ingested crystal gel ball and presented with vomiting for a month. On radiological imaging it was interpreted as duplication cyst of the duodenum. At operation, crystal gel ball was retrieved. Our case vindicates importance of keeping various possibilities in mind as differential diagnoses during evaluation and management of surgical ailments such as the duplication cyst of duodenum.

A case of ingested water beads diagnosed with point-of-care ultrasound

“…Other reported cases of water bead ingestion have noted median delays in diagnosis of 3 days (range, 15 hours to 1 month) and the obstructions were more distal than in this case (Table 1). 1,2,[5][6][7][8] Of note, the diagnosis in this case was made before the toys passed the second part of the duodenum, which is the typical boundary of endoscopy. An ultrasound diagnosis of water bead ingestion has been reported in three cases.…”

“…However, the diagnoses were made 2 days to 1 month after symptom onset, and all patients underwent surgical removal (Table 1). 1,2,[5][6][7][8] Despite the larger number of ingested water beads in our case, the early detection with POCUS prevented surgery, which is the usual procedure in such cases. 2,[5][6][7][8] A couple of pitfalls were noted in using POCUS to detect ingested water beads.…”

Two cases of intestinal obstruction due to ingestion of water beads

“…방사선 투과성을 띠는 수정토는 일반영상에서는 보이지 않고 컴퓨터단층촬영 또는 초음파에서 장 내부의 둥근 종괴로 발견되는 경우가 종종 있어, 장중복증 및 난소낭종 등으로 의심되는 경우가 많다 3,6,7) . 초음파에서 수정토가 경계가 명확하고 둥근 저에코 낭종으로 보인다는 점을 인지하고, 수정토를 가지고 놀았던 환자가 본 증례처럼 장폐쇄를 시사하는 증상을 보인다면, 조기에 응급현장초음파(point-of-care ultrasound)를 시행하는 것이 바람직하다 6) .…”

“…초음파를 이용해 수정토의 위치를 파악하면, 조기에 내시경을 시행하여 불필요한 수술을 피하는 데에 도움이 될 수 있다 6) . 수정토 섭취에 의한 장폐쇄를 수술로 치료한 증례는 한국, 미국, 인도, 캐나다 등에서 여러 차례 보고됐다 [7][8][9][10] . 이 중 2개 이상의 수정토 섭취로 두 차례의 수술이 필요한 경우도 있으며 4,11,12) , 여러 차례 수술 후 사망하기도 했다 13) .…”

Multiple ileal perforations as late complications of electrical injury: A rare case report

“…Optimal enteral nutrition and early recognition of sepsis may help reduce the risk of perforation [ 3 ]. The treatment varies from primary closure with or without protective colostomy to exteriorization and the Hartmann operation [ 4 ] ( Fig. 1 ).…”