Published online Aug 6, 2019. doi: 10.12998/wjcc.v7.i15.2087
Peer-review started: February 22, 2019
First decision: May 31, 2019
Revised: June 25, 2019
Accepted: July 2, 2019
Article in press: July 3, 2019
Published online: August 6, 2019
Gastric duplication cysts (GDCs) are a relatively uncommon congenital developmental abnormality, mainly occurring in infants but very rarely in adults. Because of the variability in clinical presentation, it is often quite challenging to diagnose GDCs in adults. We are presenting a case report of an adult diagnosed operatively as having a GDC with a literature review to summarize clinical and imaging features and the treatment selections of GDCs in adults so that doctors could have a comprehensive understanding of this disease and make a precise diagnosis and a suitable therapeutic decision for patients.
A 51-year-old man presented with recurrent epigastric pain and fullness for two years. No significant findings were noted during physical examination and routine blood tests were unremarkable. An abdominal ultrasound revealed a large cyst in the upper left abdominal quadrant. A following contrast-enhanced abdominal computed tomography (CT) scan demonstrated a hypodense cystic lesion between the spleen and stomach. The lesion had scattered calcification in the cyst wall without any significant enhancement. The lesion was initially thought to be a cystic lymphangioma. The patient underwent a surgical resection and intraoperatively it was noted that the lesion was closely adherent to the greater curvature of the stomach. Subsequently, a resection of the gastric mass along with a partial gastrectomy was performed. The patient recovered quickly with a complete symptomatic relief and did not show any further complications during the 8-month follow-up.
GDCs are quite rare in adults, with a multitude of symptoms, which is quite challenging for precise diagnosis before histological examination. Some imaging techniques involving CT, magnetic resonance imaging, and endoscopic ultrasound could provide valuable morphological features for differential diagnosis.
Core tip: We are presenting a rare case of a duplication cyst in an adult complaining of recurrent upper left abdominal pain and fullness. An abdominal ultrasound and a contrast-enhanced computed tomography scan demonstrated a large cystic lesion along the greater curvature of the stomach with scattered calcification and no significant enhancement was observed. A nutrient vessel arising from the stomach was noted in the cyst wall. Laparoscopic resection of the gastric mass and partial gastrectomy were performed. The patient recovered without any complications.