Case Report
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World J Gastroenterol. Oct 14, 2013; 19(38): 6490-6493
Published online Oct 14, 2013. doi: 10.3748/wjg.v19.i38.6490
A case of a duodenal duplication cyst presenting as melena
Seung Yeon Ko, Sun Hye Ko, Sungeun Ha, Mi Sung Kim, Hyang Mi Shin, Myong Ki Baeg
Seung Yeon Ko, Department of General Surgery, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea
Sun Hye Ko, Sungeun Ha, Mi Sung Kim, Myong Ki Baeg, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea
Hyang Mi Shin, Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea
Author contributions: Ko SH, Ha S and Kim MS were the attending physicians; Ko SY performed the surgery; Shin HM performed the pathologic analysis; Ko SY and Baeg MK wrote the paper.
Correspondence to: Myong Ki Baeg, MD, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, South Korea. baegmk@Catholic.ac.kr
Telephone: +82-2-22582045 Fax: +82-2-22582053
Received: May 3, 2013
Revised: June 1, 2013
Accepted: June 8, 2013
Published online: October 14, 2013
Abstract

Duodenal duplication cysts are benign rare congenital anomalies reported mainly in the pediatric population, but seldom in adults. Symptoms depend on the type and location and can present as abdominal pain, distension, dysphagia or dyspepsia. They have been reported to be responsible for duodenal obstruction, pancreatitis and, in rare cases, gastrointestinal bleeding. We present a case of a duodenal duplication cyst in a 43-year-old man presenting as melena. Initial gastroduodenoscopy and colonoscopy did not reveal any bleeding focus. However, the patient began passing melena after 3 d, with an acute decrease in hemoglobin levels. Subsequent studies revealed a duplication cyst in the second portion of the duodenum which was surgically resected. Histology revealed a duodenal duplication cyst consisting of intestinal mucosa. There was no further bleeding and the patient recovered completely. In rare cases, duodenal duplication cysts might cause gastrointestinal bleeding and should be included in the differential diagnosis.

Keywords: Gastrointestinal hemorrhage, Duodenum, Duplication

Core tip: Duodenal duplication cysts are rare congenital anomalies that have been seldom reported in adults. Most cases of duodenal duplication have been associated with pancreatitis or jaundice and few have been reported as a cause of gastrointestinal hemorrhage. We submit a case of duodenal duplication cyst causing gastrointestinal hemorrhage. In rare cases, duodenal duplication cysts may cause gastrointestinal bleeding and must be included in the differential diagnosis.