Published online Oct 14, 2013. doi: 10.3748/wjg.v19.i38.6500
Revised: July 5, 2013
Accepted: July 17, 2013
Published online: October 14, 2013
Intestinal duplication is an uncommon congenital condition in young adults. A 25-year-old man complained of chronic, intermittent abdominal pain for 3 years following previous appendectomy for the treatment of suspected appendicitis. Abdominal discomfort and pain, suggestive of intestinal obstruction, recurred after operation. A tubular mass was palpable in the right lower quadrant. Computed tomography enterography scan identified suspicious intestinal intussusception, while Tc-99m pertechnetate scintigraphy revealed a cluster of strip-like abnormal radioactivity in the right lower quadrant. On exploratory laparotomy, a tubular-shaped ileal duplication cyst was found arising from the mesenteric margin of the native ileal segment located 15 cm proximal to the ileocecal valve. Ileectomy was performed along with the removal of the duplication disease, and the end-to-end anastomosis was done to restore the gastrointestinal tract continuity. Pathological examination showed ileal duplication with ectopic gastric mucosa. The patient experienced an eventless postoperative recovery and remained asymptomatic within 2 years of postoperative follow-up.
Core tip: We reported a case of duplication of the alimentary tract involving the ileum, which mimicked intestinal intussusception, Meckel’s diverticulum (MD) and Crohn’s disease, in a young man. Computed tomography enterography identified the intussusception in the right lower quadrant, and the disease was positive on Tc-99m pertechnetate scintigraphy. Exploratory laparotomy and surgical pathology showed ileal duplication cyst with complicating ectopic gastric mucosa. Differential diagnosis of ileal duplication cyst was made, especially from MD.