1
|
Yin H, Yu J, Chen Y. Low-grade mucinous neoplasm originating from intestinal duplication: a case report and review of the literature. World J Surg Oncol 2025; 23:20. [PMID: 39856729 PMCID: PMC11761728 DOI: 10.1186/s12957-025-03682-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 01/19/2025] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND Low-grade mucinous neoplasms typically originate from the appendix and are characterized by a lining of low-grade mucus-secreting columnar epithelial cells and smooth muscle. However, atypical origins can occur, as demonstrated in this case report. CASE PRESENTATION We present a case involving a 33-year-old male who, upon physical examination, was found to have an abdominal mass. A computed tomography (CT) scan revealed a cystic mass located between the pancreatic tail and the adjacent bowel duct, with significant enhancement of the cyst wall observed on contrast-enhanced imaging. The patient subsequently underwent laparoscopic surgical resection of the mass, and the resected specimen was sent for pathological evaluation. The pathology results were consistent with the histological morphology and immunohistochemical characteristics of low-grade mucinous tumors arising from intestinal duplication. Three and a half years post-resection, the patient returned for a follow-up examination, during which abdominal CT and blood tumor markers indicated no signs of tumor recurrence. CONCLUSIONS While low-grade mucinous tumors predominantly originate from the appendix, this case illustrates an unusual occurrence of such neoplasms arising from intestinal duplication. This report aims to enhance clinical awareness of low-grade mucinous tumors originating from intestinal duplication, thereby improving the rates of preoperative diagnosis and reducing instances of misdiagnosis.
Collapse
Affiliation(s)
- Huihui Yin
- Cancer Center, Department of Pathology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, Zhejiang, 310014, China
| | - Jie Yu
- Cancer Center, Department of Pathology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, Zhejiang, 310014, China
| | - Yunzhao Chen
- Cancer Center, Department of Pathology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, Zhejiang, 310014, China.
- Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China.
- Clinical Research Center for Cancer of Zhejiang Province, Hangzhou, Zhejiang, 310014, People's Republic of China.
| |
Collapse
|
2
|
Lee H, An HR, Kim CW, Park YS. Tubular adenoma arising in tubular colonic duplication: a case report. J Pathol Transl Med 2024; 58:198-200. [PMID: 38952256 PMCID: PMC11261168 DOI: 10.4132/jptm.2024.06.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 07/03/2024] Open
Abstract
Colonic duplication constitutes a rare congenital anomaly, characterized by the presence of hollow cystic or tubular structures exhibiting an epithelial-lined intestinal wall. Diagnostic challenges persist due to its low incidence and manifestation of nonspecific symptoms such as abdominal pain or constipation, resulting in a reluctance to pursue surgical resection. As associated malignancies in colonic duplication are rare, the inherent malignant potential of these anomalies remains undetermined. Additionally, despite reported instances of associated malignancies in colonic duplication, there is an absence of reports in the literature detailing tubular adenoma within these cases. The histologic features of the presented case are particularly noteworthy, situated at the precancerous stage, intimating potential progression towards adenocarcinoma within colonic duplication.
Collapse
Affiliation(s)
- Heonwoo Lee
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyeong Rok An
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chan Wook Kim
- Division of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Soo Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
3
|
Tirrell TF, Demehri FR, Lillehei CW, Borer JG, Warf BC, Dickie BH. Hindgut Duplication in an Infant with Omphalocele-Exstrophy-Imperforate Anus-Spinal Defects (OEIS) Complex. European J Pediatr Surg Rep 2022; 10:e45-e48. [PMID: 35282303 PMCID: PMC8913173 DOI: 10.1055/s-0041-1742154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/16/2020] [Indexed: 10/28/2022] Open
Abstract
Introduction The congenital anomaly of omphalocele, cloacal exstrophy, imperforate anus, and spinal abnormalities (OEIS complex) is rare but well recognized. Hindgut duplications are also uncommon and are not known to be associated with OEIS. We describe a neonate with OEIS who was found to have fully duplicated blind-ending hindguts. Case Report A premature infant boy with OEIS underwent first-stage closure on day of life 6, which included excision of the omphalocele sac, separation of the cecal plate and bladder halves, tubularization of the cecal plate, hindgut rescue with end colostomy, and joining of the bladder halves. Cecal plate inspection revealed two hindgut structures that descended distally, one descended midline into the pelvis along the sacrum and the second laterally along the left border of the sacrum. Both lumens connected to the cecal plate and had separate mesenteries. In an effort to maximize the colonic mucosal surface area, the hindgut segments were unified through a side-to-side anastomosis, creating a larger caliber hindgut. The cecal plate was tubularized and an end colostomy was created. Bowel function returned and he was discharged home on full enteral feeds. Discussion This case represents a cooccurrence of two extremely rare and complex congenital anomalies. The decision to unify the distinct hindguts into a single lumen was made in an effort to combine the goals of management for both OEIS and alimentary duplications. The hindgut is abnormal in OEIS and should be assessed carefully during repair.
Collapse
Affiliation(s)
- Timothy F Tirrell
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Farokh R Demehri
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Craig W Lillehei
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Joseph G Borer
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Benjamin C Warf
- Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Belinda H Dickie
- Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, United States
| |
Collapse
|
4
|
Radhakrishnan L, George J, Abraham LK. Right-Sided Colonic Duplication Cyst with a Malignant Twist in a Young Adult - a Case Report. J Gastrointest Cancer 2021; 53:805-808. [PMID: 34279795 DOI: 10.1007/s12029-021-00671-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Affiliation(s)
| | - Joseph George
- Department of Surgical Gastroenterology, Rajagiri Hospital, Aluva, Kerala, India
| | - Latha K Abraham
- Department of Pathology, Rajagiri Hospital, Aluva, Kerala, India.
| |
Collapse
|
5
|
Tessely H, Montanier A, Chasse E. Gastric duplication cyst with elevated CEA level: a case report. J Surg Case Rep 2018; 2018:rjy114. [PMID: 29942466 PMCID: PMC6007364 DOI: 10.1093/jscr/rjy114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 04/23/2018] [Accepted: 05/07/2018] [Indexed: 01/07/2023] Open
Abstract
Gastrointestinal tract duplications are congenital malformations rarely seen in adulthood. Gastric duplications (GD) represent 2-9% of it. Malignant transformation of GD is a rare complication described in the literature. We present the case of a 43-year-old man, who presented an abdominal mass and an elevated CEA level. A total gastrectomy was performed and the histological examination described a gastric duplication cysts (GDC) without malignant transformation. It is not the first case of elevation of CEA in GDC without evidence of malignancy described in the literature. Some authors think that GDC are premalignant lesions that envolve with the time to carcinomas. It is recommend that once the GDC is diagnosed to remove surgically the entire cyst even if the patient is asymptomatic.
Collapse
Affiliation(s)
- Héloïse Tessely
- Department of Abdominal Surgery, Epicura Hospital, 7301 Hornu, Belgium
| | - Aude Montanier
- Department of Abdominal Surgery, Epicura Hospital, 7301 Hornu, Belgium
| | - Emmanuel Chasse
- Department of Abdominal Surgery, Epicura Hospital, 7301 Hornu, Belgium
| |
Collapse
|
6
|
Tubular Duplication of the Midgut Presenting with Acute Abdomen and Hematochezia: A Case Report from Northern Tanzania. Case Rep Surg 2018; 2018:2858723. [PMID: 29670800 PMCID: PMC5833192 DOI: 10.1155/2018/2858723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/14/2017] [Indexed: 11/21/2022] Open
Abstract
Enteric duplication is one of the rare malformations affecting the small intestine more than the other parts of the gastrointestinal tract. It poses a challenge in diagnosis due to nonspecific symptoms that may mimic other pathologies. Furthermore, the management options including total resection, mucosal striping, and internal drainage of the duplicate depend on the presentation of the patient, site, and length of the involved bowel. We present the first documented case of enteric duplication in Tanzania, a 3-year-old male, who was found to have a 90 cm long jejunoileal duplicate. We discuss the presentation and management offered.
Collapse
|
7
|
|
8
|
Abstract
Enteric duplications have been described throughout the entire gastrointestinal tract. The usual perinatal presentation is an abdominal mass. Duplications associated with the foregut have associated respiratory symptoms, whereas duplications in the midgut and hindgut can present with obstructive symptoms, perforation, nausea, emesis, hemorrhage, or be asymptomatic, and identified as an incidental finding. These are differentiated from other cystic lesions by the presence of a normal gastrointestinal mucosal epithelium. Enteric duplications are located on the mesenteric side of the native structures and are often singular with tubular or cystic characteristics. Management of enteric duplications often requires operative intervention with preservation of the native blood supply and intestine. These procedures are usually very well tolerated with low morbidity.
Collapse
Affiliation(s)
- Paul M Jeziorczak
- Division of Pediatric Surgery, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri
| | - Brad W Warner
- Division of Pediatric Surgery, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri
| |
Collapse
|
9
|
Fernandez N, Morrison L, Liuti T, Frame M, Yool D. Type Ia (spherical) communicating colonic duplication in a dog treated with colectomy. J Small Anim Pract 2017; 58:298-300. [PMID: 28133735 DOI: 10.1111/jsap.12634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 01/11/2016] [Accepted: 01/22/2016] [Indexed: 12/21/2022]
Abstract
A six-month-old Labrador retriever presented for investigation of a colonic mass identified as an incidental finding during exploratory coeliotomy. Computed tomography identified a lesion in the colon which occupied part of its lumen and shared blood supply with the remainder of the colon. The lesion was suspected to be a colonic duplication and it was excised by segmental colectomy during exploratory coeliotomy. Histopathology from the excised colon confirmed the diagnosis of a colonic duplication. The dog recovered uneventfully and had no complications. To the authors' knowledge, this is the first report of an asymptomatic, spherical, communicating colonic duplication and the first report to describe segmental colectomy for the management of this condition in veterinary patients.
Collapse
Affiliation(s)
- N Fernandez
- Hospital for Small AnimalsRoyal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, Edinburgh, EH25 9RG, Scotland
| | - L Morrison
- Hospital for Small AnimalsRoyal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, Edinburgh, EH25 9RG, Scotland
| | - T Liuti
- Hospital for Small AnimalsRoyal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, Edinburgh, EH25 9RG, Scotland
| | - M Frame
- Hospital for Small AnimalsRoyal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, Edinburgh, EH25 9RG, Scotland
| | - D Yool
- Hospital for Small AnimalsRoyal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, Edinburgh, EH25 9RG, Scotland
| |
Collapse
|
10
|
Abstract
Right lower quadrant pain in children can result from various underlying conditions other than acute appendicitis. The common mimics of acute appendicitis are related to acute gastrointestinal and genitourinary diseases. Diagnosis of right lower quadrant pain in the pediatric population can be challenging, especially when the symptoms are often nonspecific. This article reviews the currently available imaging techniques for evaluating a child with right lower quadrant pain and the spectrum of differential diagnoses with a focus on imaging clues to a specific diagnosis.
Collapse
|
11
|
Matsumoto Y, Tohma T, Miyauchi H, Suzuki K, Nishimori T, Ohira G, Narushima K, Muto Y, Maruyama T, Matsubara H. A case of giant ileal duplication in an adult, successfully treated with laparoscope-assisted surgery. Surg Case Rep 2016; 1:10. [PMID: 26943378 PMCID: PMC4747944 DOI: 10.1186/s40792-015-0019-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/09/2015] [Indexed: 01/29/2023] Open
Abstract
Alimentary tract duplication is a rare congenital malformation but can occur anywhere along the digestive tract. Most patients become symptomatic in early childhood, and only a few cases of adult patients have been reported in the literature. We herein report a unique case of a giant ileal duplication in an adult, which was successfully treated with laparoscope-assisted surgery. A 60-year-old male was admitted because of abdominal pain. Imaging studies revealed a well-defined cystic mass, measuring 15 cm, in the ileocecal region. We diagnosed it as a duplicated ileum and performed laparoscope-assisted surgery. The duplication was successfully resected with attached normal ileum, and there were no major complications in the postoperative course.
Collapse
Affiliation(s)
- Yasunori Matsumoto
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Takayuki Tohma
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Hideaki Miyauchi
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Kazufumi Suzuki
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Takanori Nishimori
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Gaku Ohira
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Kazuo Narushima
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Yorihiko Muto
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Tetsuro Maruyama
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1Inohana, Chuo-Ku, Chiba-Shi, Chiba, 260-8670, Japan.
| |
Collapse
|
12
|
Nakamura Y, Takifuji K, Mizumoto Y, Hotta T, Yokoyama S, Matsuda K, Watanabe T, Mitani Y, Ieda J, Yamaue H. Carcinoma Arising in Duplication of the Ileum. THE JAPANESE JOURNAL OF GASTROENTEROLOGICAL SURGERY 2016; 49:447-454. [DOI: 10.5833/jjgs.2015.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2025]
Affiliation(s)
- Yuki Nakamura
- Second Department of Surgery, Wakayama Medical University
| | | | - Yuki Mizumoto
- Second Department of Surgery, Wakayama Medical University
| | - Tsukasa Hotta
- Second Department of Surgery, Wakayama Medical University
| | - Shozo Yokoyama
- Second Department of Surgery, Wakayama Medical University
| | - Kenji Matsuda
- Second Department of Surgery, Wakayama Medical University
| | | | | | - Junji Ieda
- Second Department of Surgery, Wakayama Medical University
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University
| |
Collapse
|
13
|
Duplication Cyst in the Third Part of the Duodenum Presenting with Gastric Outlet Obstruction and Severe Weight Loss. Case Rep Surg 2015; 2015:749085. [PMID: 26649220 PMCID: PMC4662982 DOI: 10.1155/2015/749085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/28/2015] [Indexed: 12/04/2022] Open
Abstract
Duodenal duplication is a rare developmental abnormality which is usually diagnosed in infancy and childhood, but less frequently in adulthood. We report a case of a 16-year-old female with a duplication cyst in the third part of the duodenum. The patient presented with symptoms of gastric outlet obstruction, including severe anorexia and weight loss. The diagnosis was made preoperatively by CT scan and upper endoscopy. The cyst was successfully treated by marsupialization on the duodenum using a GIA stapler. Duodenal duplication presents with a wide variety of symptoms. Although illusive, many cases can be properly diagnosed preoperatively by using the appropriate imaging modalities. Treatment choices are tailored according to the size and location of the cyst, in addition to its relation to adjacent structures. The outcomes are favorable in the majority of patients.
Collapse
|
14
|
Jehangir S, Ninan PJ, Jacob TJ, Eapen A, Mathai J, Thomas RJ, Karl S. Enteric duplication in children: Experience from a tertiary center in South India. J Indian Assoc Pediatr Surg 2015; 20:174-8. [PMID: 26628808 PMCID: PMC4586979 DOI: 10.4103/0971-9261.164246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Enteric duplications (EDs) are rare aberrations of the embryonic gut. This study was undertaken to define the clinical characteristics and management challenges of this unusual entity in the Indian population. Materials and Methods: Hospital records of 35 children with 38 ED operated between 2003 and 2014 were analyzed and followed up. Results: The median age at presentation was 285 days (range 1-day to 16 years) with male preponderance (71%). Small bowel duplications were the most common (44%), and thoracoabdominal duplications were seen in 8% children compared to 2% in the literature. The median duration of symptoms was 18 days (interquartile range [IQR] 3-210 days). Associated anomalies were seen in 49% children with vertebral and spinal anomalies being the most common. Ultrasonogram (US) was done in 83% children and had a sensitivity of 55%. In the presence of a gastrointestinal bleed, Technetium99m pertechnetate scintigraphy scan had a positive predictive value of 80%. Thirty-five lesions were completely removed. Mucosectomy was done in two children, and one total colonic duplication was left in situ after providing adequate internal drainage. There was no postoperative mortality. The follow-up was possible in 66% children. Conclusions: EDs are uncommon and have varied, nonspecific symptoms. Thoracoabdominal duplications are more common in the Indian population. The US is a good screening tool but requires a high index of suspicion where complete excision is not possible; the provision of adequate internal drainage is an acceptable alternative. The long-term prognosis of children with ED depends on the extent of physiological disturbance due to associated anomalies.
Collapse
Affiliation(s)
- Susan Jehangir
- Department of Pediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pradeep Joseph Ninan
- Department of Pediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Tarun John Jacob
- Department of Pediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anu Eapen
- Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
| | - John Mathai
- Department of Pediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Reju Joseph Thomas
- Department of Pediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sampath Karl
- Department of Pediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
15
|
Abstract
Alimentary tract duplications are rare congenital anomalies that usually present in childhood and occasionally in adults. They are most common in the ileum, but can occur anywhere along the alimentary tract from the mouth to the anus. We report a 24-year-old woman who presented with a giant chylous ileum cyst duplication. To our knowledge, there is only one other report of a patient with a giant chylous cyst in the literature.
Collapse
|
16
|
Affiliation(s)
- Anupamaa J. Seshadri
- Department of Surgery Brigham and Women's Hospital Harvard Medical School Boston, Massachusetts
| | - Ronald Bleday
- Department of Surgery Brigham and Women's Hospital Harvard Medical School Boston, Massachusetts
| |
Collapse
|
17
|
Patiño Mayer J, Bettolli M. Alimentary tract duplications in newborns and children: diagnostic aspects and the role of laparoscopic treatment. World J Gastroenterol 2014; 20:14263-71. [PMID: 25339813 PMCID: PMC4202355 DOI: 10.3748/wjg.v20.i39.14263] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/22/2014] [Accepted: 06/14/2014] [Indexed: 02/06/2023] Open
Abstract
Alimentary tract duplications are rare congenital lesions normally diagnosed in newborns and children that can occur anywhere from the mouth to the anus and have a reported incidence of approximately 1 in 4500 life births. Symptoms and clinical presentation vary greatly. The presentation varies according to age and location. The treatment finally is surgical; total resection when possible should be the aim of the intervention. In pediatric surgery minimally invasive surgical procedures became more and more important over the last decades. In consequence the operative procedure on alimentary tract duplications changed in this manner. We review on case reports and clinical reports on minimally invasive surgery in the treatment of alimentary tract duplications, determine the importance of minimally invasive techniques in the treatment of this rare entity and rule out that further studies in the field should be performed.
Collapse
|
18
|
Kang M, An J, Chung DH, Cho HY. Adenocarcinoma arising in a colonic duplication cyst: a case report and review of the literature. KOREAN JOURNAL OF PATHOLOGY 2014; 48:62-5. [PMID: 24627698 PMCID: PMC3950238 DOI: 10.4132/koreanjpathol.2014.48.1.62] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 05/13/2013] [Accepted: 05/14/2013] [Indexed: 12/12/2022]
Affiliation(s)
- Myunghee Kang
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Jungsuk An
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Dong Hae Chung
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Hyun Yee Cho
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| |
Collapse
|
19
|
Kwak JM, Boo YJ, Kim J. Tubular colorectal duplication presenting as rectovaginal fistula. ANZ J Surg 2013; 84:289-90. [PMID: 24165471 DOI: 10.1111/ans.12234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jung Myun Kwak
- Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | | | | |
Collapse
|
20
|
Multiple duplication cysts diagnosed prenatally: case report and review of the literature. Pediatr Surg Int 2013; 29:397-400. [PMID: 23371299 DOI: 10.1007/s00383-012-3231-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2012] [Indexed: 02/07/2023]
Abstract
Enteric duplication cysts (EDC) are typically solitary lesions that occur throughout the alimentary tract. Postnatal diagnosis is often prompted when complications occur from bleeding, obstruction, or infection. We present a case of multiple EDC diagnosed prenatally, managed with prenatal and neonatal follow-up and resection in infancy. Prenatal detection allowed for optimal management prior to the development of symptoms or complications.
Collapse
|
21
|
Rectal duplication, rare cause of constipation — case report. Open Med (Wars) 2012. [DOI: 10.2478/s11536-012-0029-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractDigestive tract duplications are uncommon congenital anomalies, encountered mostly in the first 3 months of life. Overall the rectum is the least common site of alimentary duplications. We represent a case of large cystic non-communicating duplication that manifested with constipation and profuse rectal bleeding. When diagnosis was established, surgery was planned and the cyst was enucleated completely. Histopathology examination confirmed the diagnosis.
Collapse
|
22
|
Ma H, Xiao W, Li J, Li Y. Clinical and pathological analysis of malignancies arising from alimentary tract duplications. Surg Oncol 2012; 21:324-30. [PMID: 23025911 DOI: 10.1016/j.suronc.2012.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 09/02/2012] [Accepted: 09/03/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Malignant change is a rare complication of alimentary tract duplications. METHODS Articles concerning malignancies arising from alimentary tract duplications published from 1955 to 2012 on PubMed were extensively reviewed. These cases were reclassified and analyzed according to sites of clinical manifestations, diagnostic examinations, methods of management, pathological findings, clinical staging and prognosis. RESULTS There were 64 citations in the literature that provided adequate descriptions of 67 cases of malignancies arising from alimentary tract duplications near the oesophagus (n = 6), stomach (n = 10), small intestine (n = 19), appendix (n = 1) and large intestine (n = 31). Among the cases described above, 57 underwent surgical treatment. In 43 patients with known prognosis, 7 died of tumour progression. In another 5 cases, the tumours recurred and metastasized recurred and metastasised after surgery at an average of 11.4 months. CONCLUSIONS For relieving symptoms and preventing malignant change, all duplications should be considered for surgery. Unfortunately, prognosis is generally poor once malignancy has occurred in the duplications.
Collapse
Affiliation(s)
- Haifen Ma
- Department of Pathology, Beilun People's Hospital, Ningbo City, Zhejiang Province, China.
| | | | | | | |
Collapse
|
23
|
Blank G, Königsrainer A, Sipos B, Ladurner R. Adenocarcinoma arising in a cystic duplication of the small bowel: case report and review of literature. World J Surg Oncol 2012; 10:55. [PMID: 22490125 PMCID: PMC3352259 DOI: 10.1186/1477-7819-10-55] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 04/10/2012] [Indexed: 02/06/2023] Open
Abstract
Enteric duplications are rare, but can occur anywhere along the digestive tract. Most of the patients become symptomatic in early childhood and only a few cases of adult patients have been reported in literature. Here we report a unique case of an adenocarcinoma arising in a coincidentally found cystic duplication of the small bowel.
Collapse
Affiliation(s)
- Gregor Blank
- Department of General, Visceral and Transplant Surgery, University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany.
| | | | | | | |
Collapse
|
24
|
Liu JF, Liu G, Xu B. Acute respiratory distress caused by esophageal duplication canceration in an adult. Gen Thorac Cardiovasc Surg 2012; 60:316-20. [PMID: 22453545 DOI: 10.1007/s11748-010-0731-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2010] [Accepted: 09/18/2010] [Indexed: 01/07/2023]
Abstract
Esophageal duplication (ED) in adults is rare, and ED canceration is very rare. We report a case of acute respiratory embarrassment caused by ED with squamous carcinoma in a 39-year-old man and a review of the literature.
Collapse
Affiliation(s)
- Ji-fu Liu
- Department of Thoracic Surgery, General Hospital of Beijing, Unit 5, Nan Men Cang, District of Dong Cheng, Beijing, 100700, PR China.
| | | | | |
Collapse
|
25
|
Martin JT, Cibull ML, Zwischenberger JB, Reda HK. Infection of an esophageal cyst following endoscopic fine-needle aspiration. Int J Surg Case Rep 2011; 2:144-6. [PMID: 22096709 DOI: 10.1016/j.ijscr.2011.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 03/25/2011] [Accepted: 03/31/2011] [Indexed: 10/18/2022] Open
Abstract
In this report, we describe an unusual presentation of an esophageal cyst. Esophageal cysts are generally benign and are frequently asymptomatic until progressive enlargement leads to symptoms of obstruction. Incidental discovery usually warrants excision. In the described case, a patient presented with signs of enlargement and concerns for infection after an attempted endoscopic biopsy of the lesion. After admission and initial management with antibiotics she was taken to the operating room for resection via a thoracotomy. We review the literature and underscore the conventional practice of operative management of esophageal cysts without the use of invasive diagnostic evaluations.
Collapse
Affiliation(s)
- Jeremiah T Martin
- Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, United States
| | | | | | | |
Collapse
|
26
|
Fiorani C, Scaramuzzo R, Lazzaro A, Biancone L, Palmieri G, Gaspari AL, Sica G. Intestinal duplication in adulthood: A rare entity, difficult to diagnose. World J Gastrointest Surg 2011; 3:128-30. [PMID: 22007281 PMCID: PMC3192219 DOI: 10.4240/wjgs.v3.i8.128] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 06/06/2011] [Accepted: 06/15/2011] [Indexed: 02/06/2023] Open
Abstract
Duplications of the alimentary tract (ATD) are rare congenital anomalies often found early in life. They may occur anywhere in the intestinal tract but the ileum is the most frequently affected site. Clinical presentation of ATD in adults is variable and because these lesions occur so infrequently they are rarely suspected. In the present report we describe a case of ileal duplication in a 61-year-old patient with Crohn’s disease. Despite various radiological investigations and medical consultations, the diagnosis was only made on the surgical specimen.
Collapse
Affiliation(s)
- Cristina Fiorani
- Cristina Fiorani, Rosa Scaramuzzo, Alessandra Lazzaro, Achille L Gaspari, Giuseppe Sica, Department of Surgical Science, Tor Vergata University Hospital, 00133 Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
27
|
Freeman HJ. Duplicated appendix complicated by appendiceal cancer. World J Gastroenterol 2011; 17:135-6. [PMID: 21218095 PMCID: PMC3016674 DOI: 10.3748/wjg.v17.i1.135] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 12/01/2010] [Accepted: 12/08/2010] [Indexed: 02/06/2023] Open
Abstract
A 37-year old male presented with an acute abdomen suggestive of an appendiceal perforation. Urgent laparotomy showed a duplicated appendix with one of the lumens involved with appendicitis and a focal peri-appendicular abscess while the other lumen had a localized appendiceal cancer. Recognition of congenital intestinal duplications in adults is important to avoid serious clinical consequences.
Collapse
|
28
|
Hsu H, Gueng MK, Tseng YH, Wu CC, Liu PH, Chen CCC. Adenocarcinoma arising from colonic duplication cyst with metastasis to omentum: A case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:41-43. [PMID: 20812340 DOI: 10.1002/jcu.20739] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Gastrointestinal tract duplications are uncommon congenital abnormalities. Carcinoma arising from duplication cyst is extremely rare, not to mention metastasis to other organs. We present a case of adenocarcinoma arising from a colonic duplication cyst with invasion of the serosa and metastasis to the omentum in a 40-year-old man. Duplication cysts should be included in the differential diagnosis of cystic masses of the gastrointestinal tract. Because these lesions occur so infrequently, they are often not suspected until encountered intraoperatively. The specific findings and advantages of sonography are reviewed.
Collapse
Affiliation(s)
- Hao Hsu
- Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
| | | | | | | | | | | |
Collapse
|
29
|
Kashiwagi Y, Suzuki S, Watanabe K, Nishimata S, Kawashima H, Takekuma K, Hoshika A. Sudden unexpected death associated with ileocecal duplication cyst and clinical review. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2010; 4:25-8. [PMID: 23761993 PMCID: PMC3667037 DOI: 10.4137/cmped.s4850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Duplications of the alimentary tract are very rare. A one-month-old female presented with symptoms of anorexia, vomiting and continuous watery diarrhea. The plain abdominal radiograph showed thickened intestinal wall and signs of small bowel obstruction. The fevers, vomiting, and continuous wartery diarrhea persisted despite antibiotics, and worsened. The patient failed to respond to medical managements, 27 hours after admission, the patient died due to multiple organ failures. The autopsy was performed, small bowel obstruction due to an ileocecal duplication cyst (3 × 3 cm) was recognized. The ileocecal duplication cyst was attached to the ileum which was changed edematous and necrotic. This potential diagnosis should be borne in mind for a patient who complains of abdominal symptoms with an unknown cause, and duplication cyst should be recognized as a fatal cause in infant.
Collapse
Affiliation(s)
- Y Kashiwagi
- Department of Pediatrics, Tokyo Medical University, Tokyo, Japan
| | | | | | | | | | | | | |
Collapse
|
30
|
Kim KH, Choi SC, Kang DB, Yun KJ. [A case of ileal duplication cyst lined by ciliated columnar and squamous epithelium]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2009; 54:42-5. [PMID: 19696549 DOI: 10.4166/kjg.2009.54.1.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Duplication is a rare congenital abnormality and may occur in any region of the gastrointestinal tract. A 19-year-old woman was admitted due to lower abdominal pain. Abdomino-pelvic CT scan showed a cystic mass interpreted as mesenteric cyst or duplication cyst. On the operation finding, it seemed to be arised from mesentery but attached to the ileum. Microscopically, the cystic wall was lined by non-keratinizing squamous, ciliated pseudostratified columnar epithelium, and ectopic gastric mucosa with two distinct muscular layers and a serosa. We report the first case of ileal duplication cyst lined by squamous and ciliated columnar epithelium in Korea.
Collapse
Affiliation(s)
- Ki Hoon Kim
- Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan, Korea
| | | | | | | |
Collapse
|
31
|
Abstract
AbstractAdenocarcinomas of Ileal Duplication Cysts are an extremely rare occurrence, this is a case report and review of current literature as to the best management of this condition.
Collapse
|
32
|
Arroud M, Lamiae C, Atmani S, Boujraf S, Afifi MA, Hida M, Bouabdallah Y. Twelve-years old girl with retro-rectal mass. Rectal duplication with gastric mucosa heterotopy. Saudi J Gastroenterol 2009; 15:145-6. [PMID: 19568589 PMCID: PMC2702966 DOI: 10.4103/1319-3767.49013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mounir Arroud
- Department of Pediatric Surgery, University Hospital Hassan II, Fez, Morocco.
| | - Chater Lamiae
- Department of Pediatric Surgery, University Hospital Hassan II, Fez, Morocco
| | - Samir Atmani
- Department of Pediatrics, University Hospital Hassan II, Fez, Morocco
| | - Said Boujraf
- Biophysics Department, Faculty of Medicine and Pharmacy, Fez, Morocco
| | | | - Moustapha Hida
- Department of Pediatrics, University Hospital Hassan II, Fez, Morocco
| | - Youssef Bouabdallah
- Department of Pediatric Surgery, University Hospital Hassan II, Fez, Morocco
| |
Collapse
|
33
|
Tomas D, Zovak M, Cicek S, Sulentić P, Jukić Z, Kruslin B. Mucinous cystadenoma arising in an isolated ileal duplication cyst. J Gastrointest Cancer 2009; 38:127-30. [PMID: 19089665 DOI: 10.1007/s12029-008-9023-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION A 64-year-old woman with a 2-year history of bilateral breast carcinoma with axillary node metastasis and chemotherapy was admitted to our hospital due to tumor attached to the ileum, discovered during the routine control examination. DISCUSSION Computerized axial tomography showed oval cystic tumor in terminal ileum that measured 7 cm in the largest diameter and shared peritoneal coat with small intestine and was filled with dense fluid. Tumor abutted intestine but did not communicate with intestinal lumen. The surgical procedure was simple because cyst was attached to the antimesenteric side of the terminal ileum and did not communicate with the adjacent intestine. Pathohistological examination showed mucinous cystadenoma with high-grade epithelial dysplasia in the isolated ileal duplication cyst. The presence of epithelial dysplasia found in duplication cyst suggested potential to undergo malignant transformation. CONCLUSION In conclusion, we report a unique case of mucinous cystadenoma arising in isolated ileal duplication cyst. This case report expands the potential range of clinical variability of alimentary tract duplications. Surgical removal of alimentary tract duplication in patients without symptoms is also recommended because many potential complications or even malignant transformation may result from these anomalies.
Collapse
Affiliation(s)
- Davor Tomas
- Ljudevit Jurak Department of Pathology, Sestre milosrdnice University Hospital, Vinogradska cesta 29, 10000, Zagreb, Croatia.
| | | | | | | | | | | |
Collapse
|
34
|
Affiliation(s)
- Minoru Iwasaki
- Department of Pediatric Surgery, Otsu Red-Cross Hospital, Shiga, Japan.
| | | | | | | | | | | |
Collapse
|
35
|
Upadhyaya VD, Srivastava PK, Jaiman R, Gangopadhyay AN, Gupta DK, Sharma SP. Duplication cyst of pyloroduodenal canal: a rare cause of neonatal gastric outlet obstruction: a case report. CASES JOURNAL 2009; 2:42. [PMID: 19138408 PMCID: PMC2631535 DOI: 10.1186/1757-1626-2-42] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 01/12/2009] [Indexed: 11/10/2022]
Abstract
BACKGROUND A 21 day old male child presented with non bilious vomiting and abdominal mass. CASE PRESENTATION This case is reported because pyloroduodenal duplication cysts are an extremely rare congenital anomaly, whose clinical presentation often mimics those of hypertrophic pyloric stenosis. Ultrasound examination showed cystic mass at pyloric region and barium study was suggestive of extrinsic mass compressing the pyloric region. A laparotomy, a tense cystic mass was present at the pyloroduodenal junction (PDC) which was resected and end to end anastomosis was done. Patients followed an uneventful recovery and doing well. CONCLUSION The clinical and radiological analysis can reveal configurational changes consistent with a large extrinsic mass rather than muscular hypertrophy and can lead to accurate preoperative diagnosis.
Collapse
Affiliation(s)
| | | | - Richa Jaiman
- Department of pediatric surgery IMS, BHU, Varanasi, India
| | | | - Dinesh K Gupta
- Department of pediatric surgery IMS, BHU, Varanasi, India
| | - Shiv P Sharma
- Department of pediatric surgery IMS, BHU, Varanasi, India
| |
Collapse
|
36
|
Milbrandt K, Sigalet D. Intussusception associated with a Meckel's diverticulum and a duplication cyst. J Pediatr Surg 2008; 43:e21-3. [PMID: 19040915 DOI: 10.1016/j.jpedsurg.2008.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Revised: 09/03/2008] [Accepted: 09/03/2008] [Indexed: 10/21/2022]
Abstract
Intussusception is a frequent cause for bowel obstructions and pediatric surgical consults. First described by Barbette in 1674, the etiology and treatment of intussusception has undergone several revisions for the last 300 years. Currently, we understand most intussusceptions in young children to be of idiopathic in nature with the incidence of pathologic lead points increasing with the age of the child. Although both Meckel's diverticulum and duplication cysts have both been reported numerous times in the past as a source of a lead point, we report, to our knowledge, the only case of both found in a child requiring operative reduction.
Collapse
Affiliation(s)
- Kris Milbrandt
- Department of Pediatric Surgery, Alberta Children's Hospital, Calgary, Alberta, Canada T3B 6A8.
| | | |
Collapse
|
37
|
Barussaud ML, Meurette G, Cassagnau E, Dupasc B, Le Borgne J. Mixed adenocarcinoma and squamous cell carcinoma arising in a gastric duplication cyst. ACTA ACUST UNITED AC 2008; 32:188-91. [PMID: 18496895 DOI: 10.1016/j.gcb.2008.01.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Malignant transformation of duplication cyst is a rare condition. The authors report the original case of a degenerated gastric duplication cyst in a 67-year-old patient. The histologic examination revealed a gastric duplication cyst infiltrated with both adenocarcinoma and squamous cell carcinoma. Local carcinomatosis was found at laparotomy. The patient died six months after complete macroscopic resection of the lesion, with metastatic disease.
Collapse
Affiliation(s)
- M-L Barussaud
- Clinique de chirurgie digestive et endocrine, CHU Hôtel-Dieu, 1, place A.-Ricordeau, 44093 Nantes, France
| | | | | | | | | |
Collapse
|
38
|
Abstract
Enteric duplication cysts are uncommon congenital anomalies that can occur anywhere along the length of the alimentary tract or nearby organs. Overall, the colon is the least common site of congenital alimentary duplications. Colonic duplication cysts can present with symptoms of diverticulitis and can be confused with acquired giant sigmoid diverticula. We present a case of a sigmoid colon duplication cyst presenting as persistent diverticulitis in an adult male. We review the literature and attempt to differentiate congenital colonic duplication cysts from the more common, acquired giant colonic diverticula.
Collapse
Affiliation(s)
| | - Najjia N. Mahmoud
- Departments of General Surgery and the
- Division of Colon and Rectal Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
39
|
Tanaka S, Goubaru M, Ohnishi A, Takahashi H, Takayama H, Nagahara T, Iwamuro M, Horiguchi S, Ohta T, Murakami I. Duodenal duplication cyst of the ampulla of Vater. Intern Med 2007; 46:1979-1982. [PMID: 18084120 DOI: 10.2169/internalmedicine.46.0451] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A 35-year-old man presented with the complaint of epigastric discomfort. Gastrointestinal endoscopy and endoscopic ultrasonography revealed a cystic lesion 20 mm in size at the ampulla of Vater. Endoscopic retrograde cholangiopancreatography (ERCP) revealed that the cystic lesion communicated with both the common bile duct and pancreatic duct via the common channel. Choledochocele was ruled out by close examination of the ERCP findings. The cystic lesion was surgically resected. Since histological findings revealed that the mucosa inside the lesion was duodenum-like and contained a layer of smooth muscle, the lesion was diagnosed as a congenital duplication cyst of the duodenum.
Collapse
Affiliation(s)
- Shouichi Tanaka
- Department of Gastroenterology, National Hospital Organization Iwakuni Clinical Center.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Landon BP, Abraham LA, Charles JA, Edwards GA. Recurrent rectal prolapse caused by colonic duplication in a dog. Aust Vet J 2007; 85:381-5. [PMID: 17760944 DOI: 10.1111/j.1751-0813.2007.00173.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 9-month-old female Shar Pei cross-bred dog was presented with a history of recurrent rectal prolapse over 7 months. Repeated reduction and anal purse string sutures and subsequent incisional colopexy failed to prevent recurrent rectal prolapse. Digital rectal examination following reduction of the prolapse identified a faeces-filled sac within the ventral wall of the rectum and an orifice in the ventral colonic wall, cranial to the pubic brim. A ventral, communicating tubular colonic duplication was diagnosed by means of a barium enema. Surgical excision of the duplicated colonic tube was performed via a caudal ventral midline laparotomy. At 20 weeks post-operation, there has been no recurrence of rectal prolapse.
Collapse
Affiliation(s)
- B P Landon
- The University of Melbourne Veterinary Clinical Centre, 250 Princes Highway, Werribee, VIC 3030, Australia.
| | | | | | | |
Collapse
|
41
|
Wakabayashi H, Okano K, Yamamoto N, Suzuki Y, Inoue H, Kadota K, Haba R. Laparoscopically resected foregut duplication cyst (bronchogenic) of the stomach. Dig Dis Sci 2007; 52:1767-70. [PMID: 17404869 DOI: 10.1007/s10620-006-9580-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 08/17/2006] [Indexed: 12/17/2022]
Affiliation(s)
- Hisao Wakabayashi
- Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan.
| | | | | | | | | | | | | |
Collapse
|
42
|
Perger L, Azzie G, Watch L, Weinsheimer R. Two Cases of Thoracoscopic Resection of Esophageal Duplication in Children. J Laparoendosc Adv Surg Tech A 2006; 16:418-21. [PMID: 16968197 DOI: 10.1089/lap.2006.16.418] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
We report two cases of thoracoscopic resection of esophageal duplication cysts. Both patients underwent successful thoracoscopic excision. They were discharged on postoperative day 2 and 4, respectively. They made uneventful recoveries and were completely asymptomatic at 1-month followup. One child was lost to long-term follow-up. In the other child, barium swallow study 10 months after surgery demonstrated a pseudodiverticulum at the site of cyst excision. Thoracoscopic resection of esophageal duplications is safe. Complete excision is possible even if the cyst shares a common muscular wall with the esophagus. Pseudodiverticulum may develop at the site of excision: follow- up is necessary and consideration should be given to closure of the muscular defect at the time of excision. To help avoid esophageal injury and, should it occur, recognize esophageal perforation, we recommend performing the dissection under intraesophageal endoscopic supervision.
Collapse
Affiliation(s)
- Lena Perger
- Department of Pediatric Surgery, University of New Mexico Children's Hospital, Albuquerque, New Mexico 87131, USA
| | | | | | | |
Collapse
|
43
|
Forshaw MJ, Dhahi D, Cole S, Parker MC. Rectal Meckel's diverticulum: an unusual cause of rectal bleeding. Int J Colorectal Dis 2006; 21:485-7. [PMID: 16080013 DOI: 10.1007/s00384-004-0685-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2004] [Indexed: 02/04/2023]
|
44
|
Hata H, Hiraoka N, Ojima H, Shimada K, Kosuge T, Shimoda T. Carcinoid tumor arising in a duplication cyst of the duodenum. Pathol Int 2006; 56:272-8. [PMID: 16669876 DOI: 10.1111/j.1440-1827.2006.01957.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Reported herein is a case of carcinoid tumor arising in a duplication cyst of the duodenum in a 34-year-old woman. Ultrasonography at a health check-up revealed a 10 cm cystic mass located in the retroperitoneum adjacent to the third portion of the duodenum. Macroscopically, it had a smooth surface without communication with other organs and was filled with brownish necrotic fluid. More than half of the inner wall was occupied by a white, irregular, and solid nodule, which protruded into the lumen. The nodule was diagnosed as a carcinoid tumor invasive to the deep muscular layer. The non-neoplastic cyst wall had bowel structures including mucosa, submucosa and double layers of smooth muscle, indicating that the lesion was a duodenal duplication cyst. Most of the mucosa was eroded by marked inflammation. The remaining mucosa consisted of various types of epithelium, the major type having the nature of primitive gastric mucosa. Of interest was the presence of hamartomatous components in the wall. Furthermore, the non-neoplastic mucosal lining cells around the carcinoid tumor expressed neuroendocrine antigens and had minimal proliferative activity, suggesting that part of the cyst wall provided a microenvironment for accelerated differentiation of epithelial cells to an endocrine phenotype and transformation to neoplasia.
Collapse
Affiliation(s)
- Hiroaki Hata
- Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan
| | | | | | | | | | | |
Collapse
|
45
|
Guarise A, Faccioli N, Ferrari M, Romano L, Parisi A, Falconi M. Duodenal duplication cyst causing severe pancreatitis: Imaging findings and pathological correlation. World J Gastroenterol 2006; 12:1630-3. [PMID: 16570360 PMCID: PMC4124300 DOI: 10.3748/wjg.v12.i10.1630] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We here report a case of a 18-year-old man with a history of recurrent abdominal pain and a previous episode of severe acute pancreatitis. Abdominal ultrasonography, contrast enhanced multislice computer tomography, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography and magnetic resonance imaging demonstrated a cystic mass lesion. Only on delayed phase magnetic resonance images after Gadolinium-BOPTA injection, it was possible to demonstrate the lesion’s relationship with the biliary tree, differentiating the lesion from intraluminal duodenal diverticulum, and to achieve the diagnosis of duodenal duplication cyst, a recognized rare cause of acute pancreatitis. The diagnosis was confirmed by histology.
Collapse
Affiliation(s)
- Alessandro Guarise
- Department of Radiology, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 37134 Verona, Italy
| | | | | | | | | | | |
Collapse
|
46
|
Martinez-Ferro M, Laje P, Piaggio L. Combined thoraco-laparoscopy for trans-diaphragmatic thoraco-abdominal enteric duplications. J Pediatr Surg 2005; 40:e37-40. [PMID: 16150332 DOI: 10.1016/j.jpedsurg.2005.05.080] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
During the last years, several thoracic and abdominal enteric duplications were resected in our institution by means of minimally invasive approaches [Rev Cir Infantil 1999;9(2):113-115]. Our last patient, however, had a giant thoraco-abdominal duodenal duplication, extending from the upper thoracic cavity to the pelvis, in a dumbbell fashion. Forty days after birth, a combined "thoraco-laparoscopy" was performed, achieving a complete resection of the cyst. The diaphragmatic defect was repaired as well. Recovery was uneventful. Based on this successful experience, we think that the thoraco-laparoscopic approach is suitable and reproducible for patients with these infrequent malformations, and even for patients with other kinds of thoraco-abdominal lesions. The purpose of this report was to describe the minimally invasive strategy used to approach the thorax and the abdomen in a single-stage procedure.
Collapse
Affiliation(s)
- Marcelo Martinez-Ferro
- Division of Pediatric Surgery, National Pediatric Hospital JP Garrahan, Buenos Aires CP 1636, Argentina.
| | | | | |
Collapse
|
47
|
Legros JR, Duclaut I, Michot F, Ténière P, Scotté M. Tumeur kystique de la région pancréatique avec augmentation du CA 19-9 révélant une duplication colique chez un adulte. ACTA ACUST UNITED AC 2004; 28:1291-3. [PMID: 15671942 DOI: 10.1016/s0399-8320(04)95224-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Intestinal duplications are rare embryologic malformations, especially in adults. We report a case of cystic duplication located near the pancreas revealed by unusual symptoms and associated with marked elevation of serum CA 19-9 levels. Although the physiopathology of the expression of CA 19-9 in duplications is unclear, this feature has been recently reported in adults and could be of interest in the diagnosis and management of intestinal duplications.
Collapse
Affiliation(s)
- Jean-Rémy Legros
- Service de Chirurgie Générale et Digestive, Hôpital Charles Nicolle, Rouen
| | | | | | | | | |
Collapse
|
48
|
Affiliation(s)
- Ruhul Amin Hassan
- Department of Pediatric Surgery & Radiology, Maternity & Childrenś Hospital, Madina Munawara, Saudi Arabia
| | | | | | | |
Collapse
|
49
|
Sasaki Y, Mikami T, Sawaya M, Ishiguro Y, Tsuji T, Fukuda S, Munakata A, Morita T, Hada R. Disrupted peristalsis in a patient with colonic duplication and chronic constipation. Gastrointest Endosc 2004; 59:589-92. [PMID: 15044908 DOI: 10.1016/s0016-5107(04)00014-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Yoshihiro Sasaki
- First Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Salameh JR, Votanopoulos KI, Hilal RE, Essien FA, Williams MD, Barroso AO, Sweeney JF, Brunicardi FC. Rectal duplication cyst in an adult: the laparoscopic approach. J Laparoendosc Adv Surg Tech A 2002; 12:453-6. [PMID: 12590729 DOI: 10.1089/109264202762252758] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Rectal duplication cyst (RDC) is a rare congenital anomaly representing 1% to 8% of all intestinal duplications. The case presented here is the first report of the laparoscopic resection of an RDC. METHODS We report the case of a 49-year-old white woman in whom a retrorectal cystic mass measuring 5 x 5.3 x 6 cm was diagnosed. The mass was completely resected by means of laparoscopic techniques. RESULTS Pathologic findings revealed a cystic structure partially lined with squamous as well as respiratory- and gastrointestinal-type epithelium. Muscularis propria was identified in the outer portions of the wall of the specimen. No atypia or malignancy was identified. The overall findings were consistent with an RDC. CONCLUSIONS Laparoscopic resection constitutes an excellent and patient-friendly approach to the management of large adult cystic duplication of the rectum.
Collapse
Affiliation(s)
- Jihad R Salameh
- Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA
| | | | | | | | | | | | | | | |
Collapse
|