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Kumar I, Meena S, Singh PK, Aggarwal P, Verma A. A Rare Cause of Acute Recurrent Pancreatitis in a Child. Indian J Pediatr 2024; 91:404-405. [PMID: 37493926 DOI: 10.1007/s12098-023-04764-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/03/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Ishan Kumar
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
| | - Sunil Meena
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Pramod Kumar Singh
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Priyanka Aggarwal
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Ashish Verma
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
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2
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Feng Y, Ye JN, Chen CQ, Zhang XH. Gastric duplication 20 years after a partial distal gastrectomy: a case report and review of literature. Ther Clin Risk Manag 2019; 15:943-949. [PMID: 31551656 PMCID: PMC6677379 DOI: 10.2147/tcrm.s206061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/14/2019] [Indexed: 12/28/2022] Open
Abstract
Gastric duplications are the least common gastrointestinal duplications, especially in adults. Duplication cyst with an accessory pancreatic lobe is extremely rare and is even more uncommon in the setting of polysplenia. No gastric duplication after partial gastrectomy has been reported. We present a 41-year-old male diagnosed with gastric duplications with an accessory pancreatic lobe and polysplenia. Another characteristic of this case is partial gastrectomy 20 years ago without the discovery of duplication cysts. The gastric duplications, accessory pancreatic lobe and accessory spleen were successfully resected.
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Affiliation(s)
- Yun Feng
- The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Jin-Ning Ye
- The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Chuang-Qi Chen
- The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Xin-Hua Zhang
- The Center for Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
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Rousek M, Kachlik D, Nikov A, Pintova J, Ryska M. Gastric duplication cyst communicating to accessory pancreatic lobe: A case report and review of the literature. World J Clin Cases 2018; 6:1182-1188. [PMID: 30613679 PMCID: PMC6306634 DOI: 10.12998/wjcc.v6.i16.1182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/07/2018] [Accepted: 11/15/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The combination of a gastric duplication cyst and duplicated part of the pancreas is an extremely rare developmental defect. The incidence in the population, or the clinical impact thereof, has not been uncovered. Symptoms are unspecific. Surgery is the treatment of choice. Timely diagnostics are of utmost importance, albeit they might be challenging at times. Being so rare, case reports are currently the only relevant source of information about the condition. Therefore each published finding is of a clinical impact.
CASE SUMMARY Our work describes the case of a 22 year-old patient, who developed idiopathic acute pancreatitis. A computed tomography scan discovered liquid collection between the antrum of the stomach and the head of the pancreas. Initially, the collection was thought to be a pancreatic pseudocyst. Endoscopic ultrasound-guided transgastric drainage showed to have only a temporary therapeutic effect. Magnetic resonance cholangiopancreatography showed an accessory pancreatic lobe with a separate duct system. The accessory pancreatic lobe exited the body of the pancreas and was in contact with the cystic collection. The patient was indicated for surgical resection. Within the surgery, an en bloc resection of the accessory pancreatic lobe was performed with the antrum of the stomach containing the gastric duplication cyst. No complications were observed in the surgery or thereafter. In the five months follow-up period, the patient was completely symptom free. Histopathological findings confirmed the gastric duplication cyst communicating to accessory pancreatic lobe.
CONCLUSION This developmental defect is extremely rare. It can cause recurrent acute pancreatitis. Diagnostics are challenging. Surgery is treatment of choice.
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Affiliation(s)
- Michael Rousek
- Department of Surgery, 2nd Faculty of Medicine, Charles University and Central Military Hospital, Prague 16002, Czech Republic
| | - David Kachlik
- Department of Anatomy, 2nd Faculty of Medicine, Charles University, Prague 15006, Czech Republic
| | - Andrej Nikov
- Department of Surgery, 2nd Faculty of Medicine, Charles University and Central Military Hospital, Prague 16002, Czech Republic
| | - Jirina Pintova
- Department of Gastroenterology, Jablonec nad Nisou Hospital, Jablonec nad Nisou 466 01, Czech Republic
| | - Miroslav Ryska
- Department of Surgery, 2nd Faculty of Medicine, Charles University and Central Military Hospital, Prague 16002, Czech Republic
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4
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Kawaida H, Kimura A, Watanabe M, Akaike H, Hosomura N, Kawaguchi Y, Amemiya H, Sudo M, Kono H, Matsuda M, Fujii H, Ichikawa D, Fukasawa M, Takahashi E, Sano K, Inoue T. Successful laparoscopic partial gastrectomy and spleen-preserving distal pancreatectomy for gastric duplication cyst connecting with the pancreatic tail. Int J Surg Case Rep 2018; 44:176-180. [PMID: 29524856 PMCID: PMC5928032 DOI: 10.1016/j.ijscr.2018.02.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 01/18/2018] [Accepted: 02/17/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Gastrointestinal duplication cyst is a congenital rare disease that may occur in any region from mouth to anus. Among them, gastric duplication cysts are very rare. CASE REPORT Here we report A 23-year-old Japanese man who visited our hospital to evaluate an abdominal tumor. Abdominal computed tomography showed a well-circumscribed homogenous low-density mass measuring 6.2 × 6.0 cm between the pancreatic tail and the upper posterior wall on the gastric greater curvature, and the mass seemed to originate from the pancreatic tail. We found intraoperatively that the mass adhered to the stomach and pancreatic tail strongly, so we performed laparoscopic partial gastrectomy and spleen-preserving distal pancreatectomy. Pathological findings showed that the lining epithelium of the cystic mass consisted of the gastric foveolar epithelium with fundic glands. Furthermore, the pancreatic tissue of the pancreatic tail and the muscular layer of the cystic mass were intermingled. DISCUSSION GDCs are usually diagnosed at a younger age and in adults, they are very rare. Therefore, surgical resection is considered to be the best treatment due to the difficulty of diagnosis, and also that it mimics a pancreatic cystic tumor, and malignant transformation. Complete resection of the cyst is the ideal technique and laparoscopic surgery should be selected whenever possible. CONCLUSION We experienced a case of GDC continuous to both stomach and pancreatic tail. Laparoscopic surgery is safety and useful even if GDC is continuous with both the stomach and the pancreas.
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Affiliation(s)
- Hiromichi Kawaida
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Ayako Kimura
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Mitsuaki Watanabe
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Hidenori Akaike
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Naohiro Hosomura
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Yoshihiko Kawaguchi
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Hidetake Amemiya
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Makoto Sudo
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Hiroshi Kono
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Masanori Matsuda
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Hideki Fujii
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Daisuke Ichikawa
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Japan.
| | - Mitsuharu Fukasawa
- First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Japan.
| | - Ei Takahashi
- First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Japan.
| | - Katsuhiro Sano
- Department of Radiology, Faculty of Medicine, University of Yamanashi, Japan.
| | - Tomohiro Inoue
- Department of Human Pathology, Faculty of Medicine, University of Yamanashi, Japan.
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5
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Enteric duplication cyst of the pancreas associated with chronic pancreatitis and pancreatic cancer. J Gastrointest Surg 2014; 18:1054-8. [PMID: 24366368 DOI: 10.1007/s11605-013-2434-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 12/09/2013] [Indexed: 01/31/2023]
Abstract
Pancreas-associated enteric duplication cysts are rare developmental anomalies that communicate with the main pancreatic duct and may be associated with recurrent acute and chronic abdominal pain in children. In adults, these lesions may masquerade as pancreatic pseudocysts or pancreatic cystic neoplasms. An adult patient with a pancreas-associated enteric duplication is described which represents the first reported instance of association with both chronic calcific pancreatitis and pancreatic cancer. The clinical spectrum of pancreas-associated enteric duplication cyst, including diagnostic and therapeutic options, is reviewed.
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Christians KK, Pappas S, Pilgrim C, Tsai S, Quebbeman E. Duplicate pancreas meets gastric duplication cyst: A tale of two anomalies. Int J Surg Case Rep 2013; 4:735-9. [PMID: 23827696 PMCID: PMC3710888 DOI: 10.1016/j.ijscr.2013.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/06/2013] [Accepted: 05/12/2013] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Congenital anomalies are a rare cause of pancreatitis in adults. Gastric duplications are the least common duplication of the gastrointestinal tract and are even more uncommon in the setting of a duplicate pancreas. PRESENTATION OF CASE This manuscript contains a case report and review of the literature of an adult who presented with recurrent pancreatitis and was found to have a gastric duplication cyst that communicated with a duplicate pancreas. The study aim is to alert practitioners to the duplicate anomaly and recommend appropriate therapy. DISCUSSION Combined gastric and pancreatic duplications usually occur in young females with nonspecific, recurrent abdominal pain. This combined duplication can result in pancreatitis when the gastric duplication is contiguous with the stomach. Heightened awareness of the condition, appropriate diagnostics with accurate interpretation and a minimalist approach to resection are warranted. CONCLUSION Recurrent abdominal pain and pancreatitis in young adults devoid of risk factors should lead to consideration of congenital anomalies. Not all cysts near the pancreas and stomach are pseudocysts. ECRP and abdominal CT/MRI provide critical diagnostic information. This dual anomaly is best treated by simple excision of the gastric duplication and heterotopic pancreas.
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7
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Intrapancreatic gastric duplication cyst mimicking pancreatic cystic tumor. Clin J Gastroenterol 2013; 6:156-9. [PMID: 26181454 DOI: 10.1007/s12328-013-0367-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 01/23/2013] [Indexed: 02/08/2023]
Abstract
Cystic lesions of the pancreas are sometimes difficult to diagnose. We report a case of a gastric duplication cyst (GDC) of the pancreas in an adult. A 45-year-old woman was admitted to our department for the investigation of anemia. Abdominal ultrasonography revealed a large cystic lesion, measuring about 40 × 70 mm with calcification in the tail of the pancreas. Contrast-enhanced computed tomography of the abdomen revealed a non-enhanced cystic lesion with non-enhanced wall. Endoscopic retrograde pancreatography revealed a mild extended main pancreatic duct and an aberrant pancreatic duct, but there was no communication with the cyst. We could not deny the malignancy, so distal pancreatectomy was performed. The pathological examination revealed that the inner wall of the cyst consisted of columnar epithelium and smooth muscle layer. Immunohistochemical analysis revealed the columnar epithelium to be immunopositive for cytokeratin 7 (CK7) and immunonegative for cytokeratin 20 (CK20) and the glands to be immunonegative for CK 7 and immunopositive for CK 20. Therefore, a diagnosis of GDC of the pancreas was made. On imaging, a GDC usually mimics a pancreatic pseudocyst or a cystic neoplasm of the pancreas. Therefore, even though it is rare, a GDC should be considered in the differential diagnosis of cystic tumors of the pancreas.
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8
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Emoto K, Mukai M, Kawachi S, Kitagawa Y, Sakamoto M. Duplication of the digestive organs in the retroperitoneum: a case report with reference to the importance of a standardized nomenclature and definition. Pathol Int 2011; 61:430-4. [PMID: 21707847 DOI: 10.1111/j.1440-1827.2011.02678.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Duplications of the digestive organs, especially in the retroperitoneum, are rare malformations. We present the case of a 20-year-old man who had recurrent abdominal pain because of a solid and cystic mass located in the retroperitoneum, posterior to the pancreatic body. Preoperative diagnosis was difficult and a resection was performed. Histopathologically, intestinal mucosa, respiratory mucosa, aberrant pancreatic tissue, smooth muscle coat, and an external fibrous capsule were found. The mass was diagnosed as a duplication of the digestive organs. Findings in the pancreatic tissue indicated chronic pancreatitis and mild atypia in the pancreatic duct epithelium. Currently, many terms are used to describe these series of malformations, including duplication, foregut cyst, gastrointestinal duplication cyst, and enteric duplication cyst. Consequently, diagnosis and investigation can be difficult. In the atlas produced by the Armed Forces Institute of Pathology, duplication is used as a standardized diagnostic nomenclature with subclassification according to the site, but this has not been uniformly accepted. In addition, there are cases whose origins are unclear, especially in the retroperitoneum. In this report, we propose that the term duplication should be uniformly used for all cases in the digestive organs, and that they may then be distinguished according to their mechanisms.
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Affiliation(s)
- Katsura Emoto
- Department of Pathology Division of Diagnostic Pathology Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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9
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Laparoscopic enucleation of a gastroenteric duplication cyst arising in a pancreatic tail that did not communicate with the pancreatic duct: report of a case. Surg Today 2010; 40:281-4. [PMID: 20180086 DOI: 10.1007/s00595-008-4051-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 09/30/2008] [Indexed: 01/11/2023]
Abstract
Gastroenteric duplication rarely occurs in locations such as the pancreas. We report a case of gastroenteric duplication of the pancreatic tail, which was noncontiguous with the stomach and had no communication with the pancreatic duct, in a 3-year-old girl. The cyst was enucleated by laparoscopy, without the need for pancreatic resection. The optimal treatment procedures vary considerably, depending on where the gastroenteric duplication is located in the pancreas and, most importantly, whether there is communication with the pancreatic duct.
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10
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Oeda S, Otsuka T, Akiyama T, Ario K, Masuda M, Taguchi S, Shono T, Kawazoe S. Recurrent acute pancreatitis caused by a gastric duplication cyst communicating with an aberrant pancreatic duct. Intern Med 2010; 49:1371-5. [PMID: 20647650 DOI: 10.2169/internalmedicine.49.3392] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A 38-year-old woman was hospitalized in August 2007. This visit was her fifth episode of acute pancreatitis. Computed tomography revealed a cystic structure located near the antrum. Communication between this structure and the pancreatic duct was revealed by endoscopic retrograde cholangiopancreatography. Ultrasonography revealed that the cyst wall had a layered structure. Thus, we regarded it as a gastric duplication cyst. We thought that the gastric duplication cyst communicating with an aberrant pancreatic duct was responsible for the recurrent acute pancreatitis. In August 2008, a cyst gastrostomy was performed between the gastric duplication cyst and the stomach. No recurrence of acute pancreatitis has since occurred.
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Affiliation(s)
- Satoshi Oeda
- Department of Internal Medicine, Saga Prefectural Hospital, Saga, Japan.
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11
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Yoshida N, Nakayama H, Hemmi A, Suzuki T, Takayama T. Duodenal stenosis caused by cystic dystrophy in heterotopic pancreas: report of a case. Surg Today 2009; 39:803-6. [PMID: 19779779 DOI: 10.1007/s00595-009-3939-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Accepted: 01/07/2009] [Indexed: 12/14/2022]
Abstract
We herein describe the first reported case of duodenal stenosis caused by cystic dystrophy in heterotopic pancreas (CDHP) in Asia. A 63-year-old man was admitted to the hospital presenting with nausea and vomiting of 2 days' duration. Laboratory examinations showed an elevation in both the serum amylase level (275 IU/l) and white blood cell count (13 600/microl). A 3-cm-diameter tumor close against the duodenum was pointed out from the results of computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP); the tumor contained a cystic and solid component. Endoscopic examinations and an upper gastrointestinal series showed stenosis of the second portion of the duodenum without any mucosal change. The tumor was considered to be located at the submucosal layer of the second duodenum. The biopsy specimen of the duodenum revealed no malignancy. We strongly doubted the presence of a malignant submucosal tumor in the duodenum based on the findings of diagnostic imaging, and a pancreaticoduodenectomy was thus performed. Histopathologically, the lesion was diagnosed to be CDHP. The postoperative course was uneventful. The patient was symptomatic but was free of any symptoms after surgery. He continues to be regularly followed up on an outpatient basis and has had no recurrence of symptoms. This case demonstrates the need to consider CDHP in the differential diagnosis as a rare cause of duodenal stenosis.
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Affiliation(s)
- Nao Yoshida
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan
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12
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Abstract
OBJECTIVES The formation of the pancreatic duct system is the result of the fusion of 2 embryonic buds, the ventral and dorsal primordia. Frequently, this fusion process is localized in the pancreatic head; variations, however, may account for the structural diversity of the duct system. Pancreatic duct anomalies and diversity of body and tail are thought to be casuistic. METHODS Ninety-nine consecutive adult autopsies with reference to macroscopic anomalies in the distal part of the gland were evaluated. Pancreatograms were performed after large duodenal papilla cannulation. Ducts parallel to gland axis with a diameter of at least one third of the main pancreatic duct at the junction point and aberrant duct with different shapes and/or abnormal third-degree ductuli architecture were noted. RESULTS Our study revealed a 9.9% frequency of main pancreatic duct diversity in the pancreatic corpus and tail. Eleven atypical ducts were visible, 9 cranially and 2 caudally from the main pancreatic duct. CONCLUSIONS The pancreatic duct system in the body and the tail presents abnormal configuration not described in the past.
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13
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Gastric-duplication cyst with an aberrant pancreatic-ductal system: an unusual cause of recurrent abdominal pain. Gastrointest Endosc 2009; 69:377-9. [PMID: 18684455 DOI: 10.1016/j.gie.2008.04.059] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Accepted: 04/13/2008] [Indexed: 02/08/2023]
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14
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Stone-containing periampullary duodenal duplication cyst with aberrant pancreatic duct. J Pediatr Surg 2009; 44:e33-5. [PMID: 19159708 DOI: 10.1016/j.jpedsurg.2008.10.106] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Revised: 09/28/2008] [Accepted: 10/26/2008] [Indexed: 02/07/2023]
Abstract
This case report describes a unique variant of a duodenal duplication cyst in an 8-year-old boy who had recurrent episodes of upper abdominal pain. Imaging revealed a stone-containing cyst near the biliaropancreatic ducts and concomitant hydrops of the gallbladder. Open transduodenal marsupialization of the cyst and resection of the inflamed gallbladder were performed. Further episodes of pancreatitis did not occur for a follow-up of 2 years.
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15
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Hishiki T, Saito T, Terui K, Mitsunaga T, Nakata M, Matsuura G, Yoshida H. A rare presentation in a case of gastric duplication cyst communicating to the pancreatic duct: coincidental detection during pyloromyotomy for hypertrophic pyloric stenosis. J Pediatr Surg 2008; 43:e1-3. [PMID: 18778980 DOI: 10.1016/j.jpedsurg.2008.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 04/03/2008] [Accepted: 04/04/2008] [Indexed: 01/15/2023]
Abstract
A rare case of gastric duplication of childhood is reported. A 1-month-old boy underwent pyloromyotomy for infantile hypertrophic pyloric stenosis. At laparotomy, a protruding lesion was identified in the anterior wall of the pylorus. The pylorus was hypertrophic as indicated preoperatively, and a normal pyloromyotomy was performed. Wedge biopsy of the protruding lesion revealed an intestinal structure, and gastric duplication was diagnosed. The child remained asymptomatic thereafter, but considering the risk of the duplication becoming symptomatic, a second laparotomy was performed at 1 year of age. The duplication cyst shared part of the wall with the pylorus, and the cyst was removed by cystectomy, leaving the pyloric muscle intact. The cyst was found to be communicating with the pancreatic duct. The child is doing well without any symptoms as of 18 months after second laparotomy. To the best of our knowledge, this is the youngest case of gastroduodenal duplication with pancreatic duct communication yet reported.
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Affiliation(s)
- Tomoro Hishiki
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan
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16
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Denève E, Ramos J, Aufort S, Marchand JP, Rousset T, Perrochia H, Domergue J, Navarro F. [Endocrine tumor arising in heterotopic gastric pancreas]. ACTA ACUST UNITED AC 2008; 32:195-201. [PMID: 18387430 DOI: 10.1016/j.gcb.2007.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2007] [Accepted: 10/04/2007] [Indexed: 10/22/2022]
Abstract
We report the case of a 49-year-old caucasian woman, in whom an endocrine tumor arising in gastric heterotopic pancreas was diagnosed. The patient was treated surgically with a gastric wedge resection. Heterotopic pancreas is a benign anatomic condition, probably widely underdiagnosed because usually asymptomatic. The malignant transformation of aberrant pancreas is very rare and almost always in adenocarcinoma. The endocrine tumors developed in heterotopic pancreas are exceedingly rare. Of our knowledge, only four cases have been published and only one case in the gastric location similar to this reported case.
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Affiliation(s)
- E Denève
- Service médicochirurgical des maladies de l'appareil digestif et de transplantation hépatique, hôpital Saint-Eloi, centre hospitalo-universitaire de Montpellier, avenue Bertin-Sans, 34295 Montpellier, France.
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17
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Hunter CJ, Connelly ME, Ghaffari N, Anselmo D, Gonzalez I, Shin C. Enteric duplication cysts of the pancreas: a report of two cases and review of the literature. Pediatr Surg Int 2008; 24:227-33. [PMID: 18060413 DOI: 10.1007/s00383-007-2084-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2007] [Indexed: 01/15/2023]
Abstract
Enteric duplication cysts are rare congenital malformations that are most commonly diagnosed in children. Enteric duplications associated with the pancreas are especially uncommon, and may present with specific clinical findings such as severe pancreatitis. These cysts often pose unique surgical challenges. In addition, the diagnosis of pancreatic duplication cysts is often difficult, and may be confused with pancreatic pseudocysts or neoplasms. Herein we report two cases of pancreatic duplication cysts, and present a complete tabulation of all case reports of pancreatic-associated duplication cysts reported in the English literature. We conclude that pancreatic duplication cysts are a rare entity, most commonly found to occur in infants and children. We further find that although severe complications may arise as a result of their presentation and treatment, the rate of post-operative complications in patients between 3 and 21 years of age is extremely low, with the highest complication rate occurring in a bimodal distribution (<3-years and >21-years of age). Despite complications in the youngest and older patient populations, surgical excision remains the mainstay of therapy for pancreatic duplication cysts in all age groups.
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Affiliation(s)
- Catherine J Hunter
- Department of Surgery, Childrens Hospital Los Angeles, 4650 Sunset Blvd., Mail Stop #35, Los Angeles, CA 90027, USA.
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18
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Wakabayashi H, Okano K, Yamamoto N, Suzuki Y, Inoue H, Kadota K, Haba R. Laparoscopically resected foregut duplication cyst (bronchogenic) of the stomach. Dig Dis Sci 2007; 52:1767-70. [PMID: 17404869 DOI: 10.1007/s10620-006-9580-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 08/17/2006] [Indexed: 12/17/2022]
Affiliation(s)
- Hisao Wakabayashi
- Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan.
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19
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Davies S, Morris-Stiff G, Lewis MH. Gastric duplication cyst mimicking a pancreatic pseudocyst in a patient with chronic pancreatitis. Int J Surg 2007; 6:e70-1. [PMID: 17499033 DOI: 10.1016/j.ijsu.2007.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Revised: 03/08/2007] [Accepted: 03/12/2007] [Indexed: 02/09/2023]
Affiliation(s)
- S Davies
- Department of Surgery, Royal Glamorgan Hospital, Ynysmaerdy, LLantrisant, Rhondda Cynon Taf, CF72 8XR, Wales, UK
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20
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Yamauchi Y, Hoshino S, Yamashita Y, Funamoto S, Ishida K, Shirakusa T. Successful Resection of an Infected Duodenal Duplication Cyst After Percutaneous Cyst Drainage: Report of a Case. Surg Today 2005; 35:586-9. [PMID: 15976957 DOI: 10.1007/s00595-004-2968-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2004] [Accepted: 10/01/2004] [Indexed: 02/06/2023]
Abstract
We report a case of a duodenal duplication cyst complicated by infection. An 8-year-old boy was brought to our hospital with severe abdominal pain and a fever of 39.8 degrees C. He had a 5-year history of occasional abdominal pain with vomiting. On examination, a cystic mass was felt under the liver. We performed percutaneous drainage of the cyst under a suspected diagnosis of a choledochal cyst complicated by acute biliary infection. A contrast study through the drainage tube and surgical exploration revealed a duodenal duplication cyst communicating with the second part of the duodenum. The patient had an uneventful recovery and remains well 5 years after surgery. To the best of our knowledge, this is the first documented case of an infected duodenal duplication cyst successfully treated by resection after percutaneous drainage.
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Affiliation(s)
- Yasushi Yamauchi
- Second Department of Surgery, Fukuoka University School of Medicine, Jonan-ku, Fukuoka 814-0180, Japan
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