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Duplications of the alimentary tract are infrequent anomalies. They are most frequently located in the terminal ileum, and majority of them became symptomatic before the age of 2. Presenting symptoms may include abdominal mass, intestinal obstruction, intussusception, rectal bleeding, and abdominal pain. Preoperative diagnosis is usually difficult,...
Context in source publication
Context 1
... fluid collection measured approximately 6 Â 4.5 cm. The patient was operated with the preliminary diagnosis of acute complicated appendicitis. Surgical exploration revealed an acute suppurative non-complicated appendicitis, and a 7 Â 6 cm non- complicated duplication cyst with a common wall with the ileum 4 cm proximal to the ileocecal valve (Fig. 1). Appendectomy, segmental ileal resection including the duplication cyst, and end- to-end ileal anastomosis was performed. Following surgery we questioned the parents for detailed past medical history, any pre- vious chronic abdominal pain, vomiting, lower GIS bleeding were noted. The patient was started on enteral feeding on ...
Citations
... Most cases are cystic duplication [4,5]. Duplication cysts feature a smooth muscle layer and are bordered with neighboring alimentary tract mucosa, which may contain ectopic gastric or pancreatic tissue [6,7]. Our cystic duplication was found in the ileum, where it is most common, and was lined by the ileal intestinal epithelium, a few tubular structures beneath the mucosa, and a common muscle layer with the adjacent intestinal tissue. ...
... Duplications, which rare anomalies of the gastro-intestinal tract, may be located in any part of the gastrointestinal system from the oral cavity to the anus [1]. Duplications are most frequently single. ...
Introduction
and importance: Duplications, which rare anomalies of the gastroin-testinal tract, may be located in any part of the gastro-intestinal system from the oral cavity to the anus. The aim of this paper is to present and discuss a case of an asymptomatic jejunal duplication cyst associated with adhesive small bowel obstruction in an elderly lady.
Case presentation
A 70-year-old female, presented to the emergency room with a history of recurrent abdominal, non-bilious vomiting, and abdominal distension for 5 days with no passage of stool and flatus for 3 days. Abdominal Computed tomography scan showed dilated fluid-filled small bowel loops with abrupt transition to collapsed small bowel associated with a focal kink and narrowing of the lumen. The patient was rushed for emergency laparotomy for diagnosis of adhesive small bowel obstruction. To our surprise, jejunal duplication cysts were found.
Clinical discussion
the intestinal duplication cysts are rare congenital anomalies. The clinical presentation is variable and depends on the site and the related complications. Surgical resection is deemed appropriate management due to known complications like obstruction, hemorrhage, perforation, and malignant degeneration.
Conclusion
It's important to include intestinal duplication in the differential diagnosis of acute abdomen.
... It has an incidence of 1 in 4500 births [3]. 85% of the duplications present before the age of two [4]. It can be either symptomatic/ may present with vague abdominal symptoms or rarely as acute abdomen. ...
... Gastrointestinal duplication cysts are uncommon congenital anomalies, 80% of which are diagnosed before 2 years of age [4]. They are of two types in general, cystic which accounts for 80% of the cases that are spherical in shape and not communicating with the bowel lumen. ...
Introduction and Importance
Duplications are the abnormal portion of the intestine, either externally attached to the intestine or intrinsically placed within the bowel lumen. Their prevalence is noted to be around one in 25,000 deliveries. The rare gastrointestinal tract duplication may be located in any part of the gastrointestinal system from the oral cavity to the anus. The most common site of enteric duplication cyst is the terminal part of the ileum. Hence, duplications in jejunum are rare.
Case Presentation
Hereby, we report a case of jejunal duplication cyst in a female neonate which was managed successfully via surgery and adequate post-operative care without any complications.
Clinical Discussion
Duplications are more frequently single. They are usually located in the mesenteric border of the associated native bowel and may vary in shape and size. Most of them are cystic, followed by tubular and mixed type, with or without other congenital anomalies. More than 80% of the cases present before the age of 2 years as an acute abdomen or bowel obstruction, but many duplications remain silent unless complications occur, and therefore may not be diagnosed until adulthood. Complications of enteric duplication cysts include volvulus, bleeding, and, rarely, malignant degeneration.
Conclusion
It is important for pediatric surgeons to include duplication cyst in the differential diagnosis if a neonate presents with features of intestinal obstruction.
This study reports an exceptional case of a 14-year-old girl with sickle cell disease that was diagnosed with agenesis of the vermiform appendix and ileal duplication. Both consist of extremely rare gastrointestinal malformations whose association has never been described. The preadolescent girl presented with abdominal pain and vomiting, and the ultrasound was suggestive of acute appendicitis. Surgical findings were agenesis of the vermiform appendix and a T-shaped ileal malformation with inflammatory changes. The patient underwent resection and ileal end-to-end anastomosis. Histopathological evaluation identified an ileal duplication, with small bowel and colonic mucosa, no communication to the adjacent ileum and ischaemic changes. At 8-month follow-up, the patient was asymptomatic.
