Presentation and Surgical Management of Duodenal Duplication in Adults

Abstract

Duodenal duplications in adults are exceedingly rare and their diagnosis remains difficult as symptoms are largely nonspecific. Clinical presentations include pancreatitis, biliary obstruction, gastrointestinal bleeding from ectopic gastric mucosa, and malignancy. A case of duodenal duplication in a 59-year-old female is presented, and her treatment course is reviewed with description of combined surgical and endoscopic approach to repair, along with a review of historic and current recommendations for management. Traditionally, gastrointestinal duplications have been treated with surgical resection; however, for duodenal duplications, the anatomic proximity to the biliopancreatic ampulla makes surgical management challenging. Recently, advances in endoscopy have improved the clinical success of cystic intraluminal duodenal duplications. Despite these advances, surgical resection is still recommended for extraluminal tubular duplications although combined techniques may be necessary for long tubular duplications. For duodenal duplications, a combined approach of partial excision combined with mucosal stripping may offer advantage.

Quiste de duplicación duodenal en un paciente pediátrico. Reporte de caso

“…Cuando el quiste compromete la cabeza del páncreas, se recomienda la realización de una pancreatoduodenectomía 3 ; en estos casos, la derivación por cistoyeyunostomía puede dar lugar a una resolución incompleta debido a la presencia de mucosa heterotópica, con el consiguiente riesgo de ulceración, perforación y desarrollo de malignidad, como ha sido informado 7,20 .…”

Intraluminal Diverticular Duodenal Duplication With Recurrent Abdominal Pain: A Case Report

“…A previous review described 96 patients with tract duplication over a 37-year period and found no evidence of tubular duodenal duplications; rather, all duodenal duplications were cystic malformations ( 11 ). Furthermore, only a few cases of tubular duodenal duplication or intraluminal duodenal diverticulum have been reported in elderly women ( 13 , 14 ). Our case was unusual and involved a diverticular and communicating type, which we referred to as an IDDD; this is the first documented instance of a giant IDDD in a child.…”

Duodenal duplication cyst: a rare cause of gastro-intestinal obstruction

“…They have diverse clinical manifestations depending in the location, the presence or not of complications and the relationship with adjacent organ especially the pancreas and the biliary tree. Recurrent nausea, vomiting, abdominal mass, pancreatitis, jaundice can be seen [5][6][7][8][9][10]. In the systematic review of Chen et al compiling 47 cases of DD cysts, 80% of patients presented with abdominal pain and only 18 patients were older than 20 years [1].…”