1
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Sehgal M, Yadav DK, Jana M. Complicated foregut duplication cyst presenting as broncho-oesophageal fistula. BMJ Case Rep 2025; 18:e262161. [PMID: 39778958 DOI: 10.1136/bcr-2024-262161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2025] Open
Abstract
Oesophageal duplication cysts are a subtype of foregut cysts, associated with the presence of ectopic gastric mucosa. Gastric acid secreted by this mucosa can lead to complications. We report one such unusual case of complication leading to the formation of broncho-oesophageal fistula in a duplication cyst. A girl in her middle childhood presented with a long-duration cough and multiple respiratory infections. On investigation, a right-sided paraoesophageal air-filled cystic lesion was identified, with a possible communication with the airway, confirmed by an oral contrast study. On further workup, a positive uptake was noted on Meckel's scan, signifying the presence of ectopic gastric mucosa. The findings were confirmed surgically and on histopathology and were consistent with a duplication cyst with broncho-oesophageal fistula. An unexplained upper respiratory tract symptomatology should mandate imaging, which would enable early detection and appropriate surgical management of such cysts in infancy and childhood.
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Affiliation(s)
- Mehak Sehgal
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Devendra Kumar Yadav
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Manisha Jana
- Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India
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2
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Lin HG, Liu M, Huang XY, Liu DS. Intra-thyroid esophageal duplication cyst: A case report. World J Clin Cases 2024; 12:2231-2236. [PMID: 38808349 PMCID: PMC11129121 DOI: 10.12998/wjcc.v12.i13.2231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/09/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Esophageal cysts are relatively rare in clinical practice, with most of the literature comprising case reports. Esophageal cysts protruding into the thyroid gland are easily misdiagnosed as thyroid tumors. No such cases have been reported so far. CASE SUMMARY This article reports the case of a 31-year-old adult male diagnosed with thyroid nodules before admission. The patient underwent left thyroidectomy and isthmusectomy. During the surgery, esophageal cysts were identified in the esophageal muscle and thyroid glands. The pathology results confirmed a nodular goiter combined with esophageal cysts. Postoperatively, the patient developed a neck infection and underwent another operation and broad-spectrum antibiotic treatment for recovery. CONCLUSION We report the first clinical case of an esophageal cyst located within the thyroid gland that was successfully treated surgically. Esophageal cyst located within the thyroid gland cause difficulties in diagnosis. In the present study, the contents of the esophageal cysts were calcified foci, and a small amount of fluid mixture, which were easily misdiagnosed as thyroid nodules and misled the surgical methods.
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Affiliation(s)
- Hong-Guo Lin
- Department of Vascular Thyroid Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Ming Liu
- Department of Vascular Thyroid Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Xue-Yang Huang
- Department of Vascular Thyroid Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Da-Sheng Liu
- Department of Vascular Thyroid Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
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3
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Endara SA, Pinto JR, Torres GA, Arias PA, Ponton MP, Molina GA. Severe dysphagia due to an esophageal duplication cyst in sixth decade, unusual presentation of a rare pathology. J Cardiothorac Surg 2023; 18:238. [PMID: 37496023 PMCID: PMC10373318 DOI: 10.1186/s13019-023-02308-z] [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: 07/30/2022] [Accepted: 06/28/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Esophageal duplication cysts are rare congenital tumors usually diagnosed and treated during childhood. Most of them are located in the mediastinum and appear as a mass besides the esophagus. Unfortunately, symptoms are non-specific and depend on the size and location of the mass; therefore, they can easily be missed. If symptoms appear, surgical resection is necessary to prevent troublesome complications. CASE PRESENTATION We present the case of a 60-year-old woman who presented with severe progressive dysphagia and epigastric pain. After further evaluation, a paraesophageal cystic mass was found, and surgery was required. Non-communicating esophageal duplication cyst was the final diagnosis. CONCLUSION Esophageal duplication cysts are a rare pathology in adults; their symptoms will vary depending on their size and location. Preoperative diagnosis is difficult as symptoms are non-specific and can be missed. If severe dysphagia, pain, or any other complication appears, surgery should not be delayed.
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Affiliation(s)
- Santiago A Endara
- Department of Surgery Division of Cardiothoracic Surgery, Hospital Metropolitano, Av. Mariana de Jesus Oe 7/47 y Conclina, Edificio Diagnostico 2000 tercer piso 3/3, Quito, Ecuador.
| | - Jaime R Pinto
- Department of Surgery, Division of Cardiothoracic Surgery, Hospital Metropolitano, Quito, Ecuador
| | - Gustavo A Torres
- Department of Internal Medicine, Division of Gastroenterology, Hospital de los Valles, Quito, Ecuador
| | - Pablo A Arias
- PGY1, General Surgery, Universidad Internacional del Ecuador (UIDE), Quito, Ecuador
| | - M Patricia Ponton
- Department of Internal Medicine, Division of Pathology, Hospital Metropolitano, Quito, Ecuador
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4
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Çinar HG, Gulmez AO, Üner Ç, Aydin S. Mediastinal lesions in children. World J Clin Cases 2023; 11:2637-2656. [PMID: 37214576 PMCID: PMC10198114 DOI: 10.12998/wjcc.v11.i12.2637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/17/2023] [Accepted: 03/24/2023] [Indexed: 04/25/2023] Open
Abstract
The mediastinum is where thoracic lesions most frequently occur in young patients. The histological spectrum of diseases caused by the presence of several organs in the mediastinum is broad. Congenital lesions, infections, benign and malignant lesions, and vascular diseases are examples of lesions. Care should be taken to make the proper diagnosis at the time of diagnosis in order to initiate therapy promptly. Our task is currently made simpler by radiological imaging techniques.
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Affiliation(s)
- Hasibe Gökçe Çinar
- Department of Pediatric Radiology, Ankara Etlik City Hospital, Ankara 06000, Turkey
| | - Ali Osman Gulmez
- Department of Radiology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan 24100, Turkey
| | - Çiğdem Üner
- Department of Pediatric Radiology, Ankara Etlik City Hospital, Ankara 06000, Turkey
| | - Sonay Aydin
- Department of Radiology, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan 24100, Turkey
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5
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Rahul S, Keshri R, Prasad R, Chaubey D, Hasan Z, Kumar V, Thakur V, Yadav R, Kumar R, Bakhtiyar A. Duplications of the alimentary tract in infants and children. FORMOSAN JOURNAL OF SURGERY 2021. [DOI: 10.4103/fjs.fjs_137_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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The Pediatric Esophagus. Dysphagia 2018. [DOI: 10.1007/174_2018_180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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7
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8
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Kawashima S, Segawa O, Kimura S, Tsuchiya M, Henmi N, Hasegawa H, Fujibayashi M, Naritaka Y. A case of cervical esophageal duplication cyst in a newborn infant. Surg Case Rep 2016; 2:30. [PMID: 27037803 PMCID: PMC4818649 DOI: 10.1186/s40792-016-0157-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/28/2016] [Indexed: 12/11/2022] Open
Abstract
Esophageal duplication cyst is a rare congenital anomaly resulting from a foregut budding error during the fourth to sixth week of embryonic development. Cervical esophageal duplication cysts are very rare and may cause respiratory distress in infancy. A full-term newborn girl who was born by normal delivery was transferred to our hospital because of swelling of the right anterior neck since birth. Cervical ultrasonography showed a 40 × 24 × 33 mm simple cyst on the right neck. Tracheal intubation was required at 2 weeks of age because of worsening external compression of the trachea. Fine-needle aspiration cytology revealed the existence of ciliated epithelium. At 1 month of age, exploration was performed through a transverse neck incision. The cyst had a layer of muscle connected to the lateral wall of the esophagus. Histopathological diagnosis was a cervical esophageal duplication cyst. We describe the clinical features of infantile cervical esophageal duplication cysts based on our experience of this rare disease in a neonate, along with a review of 19 cases previously reported in literature.
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Affiliation(s)
- Shoko Kawashima
- Department of Surgery, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishi Ogu, Arakawa-ku, Tokyo, 116-8567, Japan.,Department of Pediatric Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Osamu Segawa
- Department of Surgery, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishi Ogu, Arakawa-ku, Tokyo, 116-8567, Japan. .,Department of Pediatric Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan.
| | - Shuri Kimura
- Department of Pediatric Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Masayoshi Tsuchiya
- Department of Surgery, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishi Ogu, Arakawa-ku, Tokyo, 116-8567, Japan.,Department of Pediatric Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Nobuhide Henmi
- Division of Neonatal Intensive Care, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishi Ogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Hisaya Hasegawa
- Division of Neonatal Intensive Care, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishi Ogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Mariko Fujibayashi
- Department of Diagnostic Pathology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishi Ogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Yoshihiko Naritaka
- Department of Surgery, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishi Ogu, Arakawa-ku, Tokyo, 116-8567, Japan
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9
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Tomar LR, Mannar V, Pruthi S, Aggarwal A. Asymptomatic thoracic esophageal duplication cyst in a young adult with bronchiectasis. Lung India 2015; 32:404-5. [PMID: 26180398 PMCID: PMC4502213 DOI: 10.4103/0970-2113.159603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Laxmikant Ramkumarsingh Tomar
- Department of Medicine, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi, India
| | - Velmurugan Mannar
- Department of Medicine, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi, India
| | - Sonal Pruthi
- Department of Medicine, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi, India
| | - Amitesh Aggarwal
- Department of Medicine, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, Delhi, India
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10
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Tooh MM, El Ezzi O, Dolci M, Boegli Y, Ikonomidis C, de Buys Roessingh A. Duplication of the cervical esophagus: An unusual cause of respiratory arrest in a child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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11
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Affiliation(s)
- S Garge
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
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12
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Owen R, Bowen J. A rare congenital neck lump. BMJ Case Rep 2012; 2012:bcr-2012-006605. [PMID: 22962394 DOI: 10.1136/bcr-2012-006605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We describe the case and present a radiological image of a neck lump identified antenatally with ultrasound imaging. Postnatally a left-sided asymptomatic neck lump was identified in the left posterior triangle of the neck. Repeat ultrasound and CT imaging were arranged confirming a cyst adjacent to the cervical oesophagus and displacing the carotid sheath anteriorly. Complete cyst excision was achieved with no complications. Histological analysis identified a 30×22×20 mm cyst with a smooth muscle layer within the cyst wall and a lining of respiratory epithelium. These findings were consistent with a diagnosis of cervical duplication cyst (CDC). Proximity to the carotid sheath and oesophagus can make CDC excision potentially dangerous hence preoperative CT scanning was useful to establish the anatomical relations of the cyst in this case.
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Affiliation(s)
- Richard Owen
- Department of General Surgery, Arrowe Park Hospital, Wirral, UK.
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13
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Wiechowska-Kozłowska A, Wunsch E, Majewski M, Milkiewicz P. Esophageal duplication cysts: Endosonographic findings in asymptomatic patients. World J Gastroenterol 2012; 18:1270-2. [PMID: 22468092 PMCID: PMC3309918 DOI: 10.3748/wjg.v18.i11.1270] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 11/17/2011] [Accepted: 12/31/2011] [Indexed: 02/06/2023] Open
Abstract
Esophageal duplication cysts are rare inherited lesions usually diagnosed in early childhood. Most of them are found in the mediastinum and manifest themselves as separate masses along or in continuity with the native esophagus. Their prevalence remains unknown and they are treated either surgically or endoscopically. In this report we describe a series of four adult patients in whom esophageal duplication cysts were localised intramurally as masses pressing on the esophageal lumen and who were diagnosed with endoscopic ultrasonography. All patients were initially referred to other centres for upper gastroduodenoscopy due to non-specific dyspeptic symptoms. After finding suspicious lesions in the esophagus their endoscopists referred them for endoscopic ultrasound examination at our centre. In two of the cases lesions mimicked esophageal varices and the other two submucosal tumours. In all four patients endoscopic ultrasonography has shown esophageal duplication cysts. Patients had no symptoms suggesting disease of the esophagus and required no treatment. As the true prevalence of esophageal cysts is unknown, it is very likely that in many patients, like in these four described by us, they may cause no symptoms, remain undetected and require no intervention. Increasing availability of new diagnostic modalities such as endoscopic ultrasonography may change the current view regarding the prevalence of esophageal duplication cysts and prove that they may, in fact, not be such rare findings.
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14
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Benson JE. The Pediatric Esophagus. Dysphagia 2012. [DOI: 10.1007/174_2012_582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Nayan S, Nguyen LHP, Nguyen VH, Daniel SJ, Emil S. Cervical esophageal duplication cyst: case report and review of the literature. J Pediatr Surg 2010; 45:e1-5. [PMID: 20850608 DOI: 10.1016/j.jpedsurg.2010.05.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Revised: 05/28/2010] [Accepted: 05/29/2010] [Indexed: 11/29/2022]
Abstract
Cervical esophageal duplication cysts are rare congenital anomalies that can be successfully managed surgically. These anomalies are rare causes of upper airway obstruction. We present here a case of a cervical esophageal duplication cyst in an infant, along with a review of the literature concerning this anomaly.
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Affiliation(s)
- Smriti Nayan
- Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Canada
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16
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Patron V, Godey B, Aubry K, Jegoux F. Endoscopic treatment of pharyngo-esophageal diverticulum in child. Int J Pediatr Otorhinolaryngol 2010; 74:694-7. [PMID: 20303603 DOI: 10.1016/j.ijporl.2010.02.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Revised: 02/21/2010] [Accepted: 02/22/2010] [Indexed: 11/26/2022]
Abstract
Pharyngo-esophageal diverticula are extremely rare among children. Treatment in adults usually consists of endoscopic resection of the crico-pharyngeal muscle but application of this surgical procedure in children has not been reported before. We report the case of a 5-year-old boy whose recurrent pulmonary infection and chronic low weight led to diagnosis of a pharyngeal diverticulum. The diverticulum was removed by endoscopic CO(2) laser surgery. No relapse occurred during the 4-year follow-up period after surgery.
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Affiliation(s)
- Vincent Patron
- Department of Head and Neck Surgery, Rennes University Hospital Center, 2 rue Henri Le Guillou, 35000 Rennes, France.
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17
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Abstract
We present a case of pharyngeal perforation from a nasogastric tube mistakenly diagnosed as esophageal atresia with tracheoesophageal fistula in a full term infant female. The correct diagnosis was identified with rigid bronchoscopy and esophagoscopy immediately prior to the planned thoracotomy which was aborted. After one week of oral restriction and antibiotics, the healed perforation did not demonstrate leakage on a contrasted pharyngoesophagogram and bottle feeds were initiated. The infant was discharged to home on day of life 13 without any further complications.
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Affiliation(s)
- Richard B Knight
- General Surgery, Wilford Hall Medical Center, San Antonio, TX 78246, USA
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18
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Conforti A, Nahom A, Capolupo I, Mobili L, Carnevale E, Bagolan P. Prenatal diagnosis of esophageal duplication cyst: the value of prenatal MRI. Prenat Diagn 2009; 29:531-2. [DOI: 10.1002/pd.2220] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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19
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Vasseur Maurer S, Schwab G, Osterheld MC, Reinberg O, Joseph JM. A 16-month-old boy vomits a double tongue: intraluminal duplication of the cervical esophagus in children. Dis Esophagus 2008; 21:186-8. [PMID: 18269657 DOI: 10.1111/j.1442-2050.2007.00755.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A 16-month-old boy presented with a story of stridor, solid dysphagia and a history of spectacular protrusion underneath his tongue which was mistaken by the parents for a snake's tongue! The radiological examinations showed a filling defect of the upper and middle third esophagus which compressed the cervical trachea. This was found to be an intraluminal tubular esophageal duplication. Treatment by cervicotomy and unusual histological facts are presented.
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Affiliation(s)
- S Vasseur Maurer
- Pediatric Surgery, University Hospital of Lausanne (CHUV), Switzerland.
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20
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Abstract
Normal anatomy, embryology, and congenital anomalies of the esophagus are discussed in this article. The classification, epidemiology, embryology, diagnosis, and management, including outcome following repair of esophageal atresia with or without an associated tracheoesophageal fistula, are described. The diagnosis and management of less common anomalies, such as congenital esophageal stenosis and congenital esophageal duplication, are outlined.
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Affiliation(s)
- Olga Achildi
- Department of Surgery, Temple University School of Medicine, 3420 North Broad Street, Philadelphia, PA 19140, USA
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21
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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.
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Affiliation(s)
- Lena Perger
- Department of Pediatric Surgery, University of New Mexico Children's Hospital, Albuquerque, New Mexico 87131, USA
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22
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Taguchi S, Tatsuta K, Ieiri S, Taguchi T, Suita S. Efficacy of OK-432 local injection for the treatment of a neonatal branchial cleft cyst: a case report. Pediatr Surg Int 2005; 21:1004-6. [PMID: 16167162 DOI: 10.1007/s00383-005-1530-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We herein present a case of a neonatal cervical cyst, which was diagnosed prenatally, and markedly decreased in size and disappeared after a local injection therapy of OK-432. A 0-day-old boy had an abnormal prenatal ultrasonography scan suggestive of rt. cervical cyst, measuring about 25 mm in diameter at 29 weeks' gestation. At birth, an elastic soft mass, measuring about 30 mm in diameter, was found on the right side of his neck. Computed tomography (CT) scans showed a giant cyst, which extended from the upper level of epipharynx to the upper mediastinum, and the contents were air and fluid. At 20 days of age, ultrasonography (US)-guided needle aspiration was performed. The aspirated fluid contained no epithelial cells, but many lymphocytes and neutrophils based on a cytological analysis. After the local injection of OK-432 had been performed four times, the right neck cyst had almost completely disappeared on US scans. During the local injection therapy, we analyzed the other sample of the second aspiration fluid of the neck cyst. Several clusters of epithelial cells, columnar epithelium, squamous cells, and ciliated epithelium were thus cytologically observed. Therefore, a final diagnosis of a branchial cleft cyst was made. The local injection of OK-432 was thus found to be an effective treatment for branchial cleft cysts.
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Affiliation(s)
- Shohei Taguchi
- Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyusyu University, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan
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23
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Moulton MSJ, Moir C, Matsumoto J, Thompson DM. Esophageal duplication cyst: a rare cause of biphasic stridor and feeding difficulty. Int J Pediatr Otorhinolaryngol 2005; 69:1129-33. [PMID: 16005356 DOI: 10.1016/j.ijporl.2005.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2004] [Accepted: 03/01/2005] [Indexed: 10/25/2022]
Affiliation(s)
- Marlene St Joan Moulton
- Department of Otorhinolaryngology Head and Neck Surgery, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
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24
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Abstract
Duplication cysts of the gastrointestinal tract are rare, particularly in adults. Endoscopic minimally invasive treatment is still a challenging approach even in the endoscopically accessible sections of the gastrointestinal tract. In a 25-year-old patient suffering from dysphagia, an endoscopy and subsequent endosonography revealed a spherical duplication cyst in the lower third of the esophagus, which prompted us to puncture the cyst and subsequently to perform a fenestration (marsupialization; diameter 1 cm) in the anterior wall of the cyst, resulting in permanent drainage of the cystic fluid. Because of the recurrent complaints of the patient after 6 weeks, the anterior wall of the duplication cyst, the former esophageal wall, was partially resected, resulting in a permanent 4-cm opening including the cystic cavity into the esophageal lumen. Thereafter, there were no further complaints from the patient and the findings in the follow-up endoscopy were normal. A successful endoscopic intervention for this type of gastrointestinal duplication cyst is described for the first time. The minimally invasive resection of the anterior wall of the esophageal duplication cyst, simultaneously with the former regular wall at this segment of the esophagus, resulted in permanent inclusion of the cystic cavity into the esophageal lumen with no disadvantageous passage of fluid and food through the lower esophagus or changes in the former cystic epithelium. This method is considered to be feasible and a reasonable treatment alternative to the more invasive surgical approach.
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Affiliation(s)
- Uwe Will
- Department of Internal Medicine III, City Hospital, Gera, Germany.
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25
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Abstract
The main role of the esophagus is to facilitate passage of food from the mouth to the stomach. A number of conditions can alter esophageal structure or function including congenital anomalies, trauma, infection, and neoplasm. This article reviews the anatomy, imaging evaluation, and common problems seen in the pediatric thoracic esophagus.
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Affiliation(s)
- Lynn Ansley Fordham
- Pediatric Radiology, Department of Radiology, University of North Carolina School of Medicine, 3325 Old Infirmary Building, CB# 7510, Chapel Hill, NC 27599-7510, USA.
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26
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Abstract
PURPOSE Thoracoscopy has an expanding role in the treatment of FD cysts (bronchogenic cysts and esophageal duplications). We examined this trend in our patients and reviewed our overall experience. METHODS All charts of children undergoing surgery for foregut duplications (FDs) in 2 pediatric hospitals between 1992 and 2003 were retrospectively reviewed. Data gathered included age, weight, symptoms, diagnostic tests, operative technique, postoperative course, complications, and outcome. RESULTS There were 39 children, with FD resected by thoracotomy in 21 patients, thoracoscopy in 11 patients (no conversions to open), cervical incision in 6 patients, and laparotomy in 1 patient for an FD near the gastroesophageal junction. Diagnosis was made by antenatal ultrasound in 7 cases. Four of these neonates had tachypnea or cough, and the rest were asymptomatic. Seventy-five percent of patients diagnosed postnatally presented with respiratory symptoms. Excision of isolated FD (without lung resection) was compared between those who had a thoracotomy (n = 16) vs thoracoscopy (n = 11). The age, weight, operating time, and anesthesia time were not different between the 2 groups. However, the thoracoscopy group had significantly fewer chest tube days (1.6 vs 3.3 days) and a shorter hospital stay (2.6 vs 6.6 days). Intraoperative complications consisted of tracheal injury in 3 patients (2 thoracotomy, 1 thoracoscopy) and esophageal mucosal injury in 2 patients (both thoracotomy), which were all recognized and repaired. CONCLUSION Foregut duplications may present in a variety of ways and locations. Thoracoscopy is advantageous for isolated intrathoracic FDs.
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Affiliation(s)
- Ioana Bratu
- Division of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, H3H-1P3, Canada
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