Recurrent Acute Pancreatitis Caused by a Gastric Duplication Cyst Communicating with an Aberrant Pancreatic Duct

Abstract

A 38-year-old woman was hospitalized in August 2007. This visit was her fifth episode of acute pancreatitis. Computed tomography revealed a cystic structure located near the antrum. Communication between this structure and the pancreatic duct was revealed by endoscopic retrograde cholangiopancreatography. Ultrasonography revealed that the cyst wall had a layered structure. Thus, we regarded it as a gastric duplication cyst. We thought that the gastric duplication cyst communicating with an aberrant pancreatic duct was responsible for the recurrent acute pancreatitis. In August 2008, a cyst gastrostomy was performed between the gastric duplication cyst and the stomach. No recurrence of acute pancreatitis has since occurred.

An unusual cause of recurrent pancreatitis: A gastric duplication cyst with an accessory pancreatic lobe

“…In patients with gastric duplication cysts communicating with aberrant pancreatic duct, abdominal pain is often related to acute pancreatitis. Recurrent acute pancreatitis caused by this anomaly have been reported in 12 cases (66%) (4)(5)(6)(7)(8)(9)(11)(12)(13)(14)16,17). Oeda et al (17) reported that there were not significant differences between the patients with pancreatitis and without pancreatitis in terms of either sex or age.…”

“…Recurrent acute pancreatitis caused by this anomaly have been reported in 12 cases (66%) (4)(5)(6)(7)(8)(9)(11)(12)(13)(14)16,17). Oeda et al (17) reported that there were not significant differences between the patients with pancreatitis and without pancreatitis in terms of either sex or age. The underlying cause of recurrent acute pancreatitis was hypothesized to be obstruction of the pancreatic duct by viscous mucus secretions, ulcer bleeding or biliary sludge (3,4).…”

“…A gastric duplication cyst communicating with an aberrant pancreatic duct is an extremely rare but curable cause of recurrent pancreatitis in children and young adults. Only 18 cases that have this unusual anomaly have been reported in the literature (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), and in minority of them an associated accessory pancreatic lobe was described (6,(10)(11)(12)(13)16). In the patients with this anomaly, a definitive diagnosis was rarely made preoperatively and several operative explorations were required in some cases (11,12).…”

Pyloric duplication with communication to the pancreas in a neonate simulating hypertrophic pyloric stenosis

“…Of these, gastric duplications make up a small subset of patients, roughly 8% [2]. To date, there are 15 case reports, in both children and adults, of gastric duplication associated with an aberrant pancreatic duct [3]. We present the youngest case of pyloric duplication with associated aberrant pancreatic lobe and duct communicating with the duplication, which presented similar to hypertrophic pyloric stenosis.…”

“…Finally, if duplication is present, careful exploration for any aberrant pancreatic lobes or ducts must be performed to avoid inadvertent ductal transaction or recurrence of the duplication cyst. Complete excision of the duplication cyst and ligation of the aberrant pancreatic duct are vital to prevent recurrence, malignant degeneration, or subsequent pancreatitis [3,6]. 4 The gastric duplication cyst is lined by normal-appearing gastric epithelium.…”