Ileocecal duplication cysts: Is the loss of the valve always necessary?

Abstract

Background: Ileocecal (IC) duplication cysts are enteric duplications located at the IC junction, not clearly identified in all the published series. The reported treatment is IC resection and ileocolic anastomosis. It is well known that the loss of the IC valve has several adverse effects. This study is aimed at demonstrating that cyst removal together with the common ileal wall and following enterorrhaphy is possible, safe, and effective in preserving the IC region. Methods: Medical records of 3 patients who underwent surgery for IC duplication between 2003 and 2013 were retrospectively reviewed evaluating follow-up results. Results: All patients had an antenatal diagnosis of intraabdominal cystic mass. In two cases associated malformations were reported. The lesions presented at newborn age with intermittent small bowel obstruction and required removal. No patients underwent IC resection. The diagnosis of duplication cyst was confirmed by histo-pathologic examination. The postoperative course was uneventful, even in the long-term follow-up. Conclusions: Our conservative approach is a simple and safe technique, effective in avoiding the loss of the IC valve in children with duplication at the IC junction.

Laparoscopic resection of ileocaecal duplication in children (report of 15 cases)

“…The chance for excision of IC duplications preserving Bauchin's valve even in the open approach has not been described until recently. [ 3 5 7 ]…”

“…In the past, children with ED underwent abdominal cyst resection of adjacent bowel or IC by laparotomy, whereas some cases received laparoscopic assisted bowel resection and ileocolic anastomosis, with the exception of 3 cases published recently by Catalano et al . [ 5 ]…”

A Systematic Review of Prenatally Diagnosed Intra-abdominal Enteric Duplication Cysts

“…35 When the enteric duplication cyst is located at the ileocecal region, ileocecetomy is often necessary. 36,37 Ileocecectomy, particularly in neonatal years, is associated with reduced intestinal transit time and impaired absorption with symptoms such as diarrhea and malnutrition, and as such is not undertaken without undue consideration. 37,38 It's plausible that delayed resection of a distal ileal lesion may allow sufficient intestinal growth to reduce the need for an ileocecectomy.…”

A Rare Cause of Intestinal Obstruction in Infants: Ileum Duplication Cyst and Literature Review

“…It was only during the laparotomy that we were able to diagnose and treat the condition. Only extremely large DCs might result in a prenatal diagnosis [ 8 ].…”