Intraluminal pyloric duplication cyst- a rare cause of non-bilious vomiting in a neonate: A case report

Abstract

Background: Duplications of the alimentary tract are rare congenital malformations, out of which, true pyloric duplications constitute only 2.2%. They present with non-bilious vomiting and mimic hypertrophic pyloric stenosis (HPS). Pyloric duplications that are intraluminal are not separately visible at laparotomy, making their diagnosis difficult. Case presentation: Our case is a neonate with an intraluminal pyloric duplication cyst who presented with recurrent vomiting. The radiological evaluation suggested a duplication cyst medial to the second part of the duodenum towards the stomach’s lesser curvature with features of gastric outlet obstruction. Intraoperatively, a cystic mass of 1 x 2 cm intraluminally was found on opening the pylorus which was excised and pyloroplasty was done. Postoperatively the baby was discharged in a stable condition. Conclusion: Intraluminal pyloric duplication cysts are rare and the clinical presentation mimics HPS. They should be considered as a differential diagnosis in a neonate presenting with features of gastric outlet obstruction.

True pylorus duplication: a case report

“…Common clinical manifestations include an abdominal mass and non bilious vomiting which are almost present in all the cases in the literature. 17 Vomiting is a shared symptom of a multitude of diseases in children. It is usually part of benign illnesses but can also be a symptom of lethal surgical emergencies.…”

“…Because of the nonspecific symptoms and rarity, the correct preoperative diagnosis is seldom possible. 17 Surgery is the undisputed mainstay of treatment. Surgical options should be individualized for each case and varies from simple excision to pyloroantrectomy.…”