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Bu YW, Han RQ, Ma WQ, Wang GN, Er LM. New treatment for gastric duplication cyst: Endoscopic ultrasonography-guided fine-needle aspiration combined with lauromacrogol sclerotherapy: A case report. World J Clin Cases 2023; 11:7905-7910. [DOI: 10.12998/wjcc.v11.i32.7905] [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: 09/22/2023] [Revised: 11/02/2023] [Accepted: 11/09/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Gastric duplication cysts are very rare disease that are mainly diagnosed by endoscopic ultrasonographic fine-needle aspiration biopsy. In the past, this disease was usually treated with traditional surgery and rarely with minimally invasive endoscopic surgery. However, minimally invasive endoscopic therapy has many advantages, such as no skin wound, organ preservation, postoperative pain reduction, early food intake, fewer postoperative complications, and shorter post-procedure hospitalization.
CASE SUMMARY We report a case of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) combined with lauromacrogol sclerotherapy for pyloric obstruction due to gastric duplication cysts.
CONCLUSION EUS-FNA combined with lauromacrogol sclerotherapy provides a new option for the treatment of gastrointestinal duplication cysts.
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Affiliation(s)
- Ya-Wei Bu
- Department of Endoscopy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Ruo-Qi Han
- Department of General Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Wen-Qian Ma
- Department of Endoscopy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Gong-Ning Wang
- Department of Endoscopy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Li-Mian Er
- Department of Endoscopy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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2
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Yuan Z, Wei H, Zhang Y, Cao B, He B, Yuan H. Gastric duplication cysts: literature review and a case report of rare multiple gastric duplication cysts treated by endoscopic submucosal dissection. Postgrad Med 2023; 135:775-783. [PMID: 37877305 DOI: 10.1080/00325481.2023.2274308] [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] [Received: 04/12/2023] [Accepted: 10/18/2023] [Indexed: 10/26/2023]
Abstract
Gastric duplication cysts (GDCs) are rare structural abnormalities, especially in adults. We first report a rare case of small multiple GDCs in a woman, which presents as a submucosal tumor (SMT) at the gastric antrum. In consideration of the patient's request for surgical treatment and minimally invasive resection, endoscopic submucosal dissection (ESD) was performed to remove the cyst. The case provides a reference for ESD surgery to remove small GDCs. So far, there is no consensus or practice guidelines for the diagnosis and management of GDCs. Herein we perform a comprehensive literature review and discussion on GDCs. GDCs are 'repetitive' cystic or tubular structures of gastric mucosa and muscularis mucosae, and share the muscularis propria and serous layer with the normal gastric wall. GDCs protruding into the stomach cavity can be diagnosed by endoscopic ultrasound (EUS), which has higher specificity and accuracy than CT and MRI. Some GDCs may cause complications, even cancerization. Therefore, we suggest that once found, the GDCs could be completely resected. For GDCs protruding into the stomach cavity, endoscopic surgery such as ESD can be adopted to remove the lesion. Endoscopic full-thickness resection (EFTR) may become an option for larger GDCs in the future. For extraluminal GDC, laparoscopic surgery is currently preferred. In this review, we summarized the structural and histopathological characteristics of GDCs and various treatment therapies, in order to provide experience and reference for the diagnosis and treatment of GDCs in the future.
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Affiliation(s)
- Ziying Yuan
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hongyun Wei
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yuejuan Zhang
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Bin Cao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Baoguo He
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hao Yuan
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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3
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Jayapal L, Kumar S, Baskaran A, Balachandar TG, Swain SK. Gastric Duplication Cyst: A Report of a Rare Case. Cureus 2023; 15:e40285. [PMID: 37448420 PMCID: PMC10336738 DOI: 10.7759/cureus.40285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Gastric duplication cysts (GDCs) are rare congenital anomalies that primarily occur in childhood but can also manifest in adults. While the ileum is the most common site of duplication, gastric duplications are infrequent. Symptomatic GDCs typically present with upper abdominal pain, vomiting, and occasionally as palpable abdominal masses. Diagnostic imaging, particularly cross-sectional techniques, plays a crucial role in identifying these cysts, and surgical resection is the definitive curative treatment. We report the case of a 44-year-old female who presented with severe right-side upper abdominal pain accompanied by non-bilious vomiting. Initial basic blood investigations yielded normal results. Subsequent contrast-enhanced computed tomography revealed a non-enhancing cystic lesion of size 9x8.5x6.5cm in the left suprarenal region lying posterior to the stomach suggestive of either a GDC or an adrenal cyst. Another hyperdense peripherally enhancing lesion was observed in the right adrenal gland, indicating a right adrenal cyst with internal hemorrhage. During laparotomy, the left side cystic lesion was found arising from the posterior wall of the greater curvature of the stomach, along with another cystic lesion of about 3x3cm originating from the right adrenal gland. Both cystic lesions were successfully excised, and the patient experienced a smooth postoperative recovery without any complications. Histopathological examination confirmed the presence of a cyst lined by gastric-type epithelium with underlying smooth muscle fibers consistent with GDCs. The right adrenal gland cystic lesion exhibited central areas of hemorrhage and necrosis.
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Affiliation(s)
- Loganathan Jayapal
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
| | - Santhosh Kumar
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
| | - Aravind Baskaran
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
| | - T G Balachandar
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
| | - Sudeepta K Swain
- Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND
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4
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Li Y, Li C, Wu H, Wang Q, Gao ZD, Yang XD, Jiang KW, Ye YJ. Clinical features of gastric duplications: evidence from primary case reports and published data. Orphanet J Rare Dis 2021; 16:368. [PMID: 34412674 PMCID: PMC8377950 DOI: 10.1186/s13023-021-01992-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/01/2021] [Indexed: 01/07/2023] Open
Abstract
Background Alimentary tract duplications are rare congenital lesions, and only 2–8% of them are located in the stomach. Gastric duplications (GD) can lead to severe adverse events. Thus, surgical resection is required once the disease is diagnosed. The main purpose of this study is to describe the clinical features of gastric duplications and to provide evidence for the diagnosis and treatment. Methods A retrospective review of eight gastric duplications at two medical centers Peking University People’s Hospital (PKUPH) and Shandong Provincial Hospital from 2010 to 2020 was conducted. Furthermore, the literature search was also conducted by retrieving data from PubMed, EMBASE and Cochrane Library databases from the date of the database inception to January 15, 2021. Results Eight patients who were diagnosed as gastric duplications and 311 published records were included in this study. In all, 319 patients were identified: Vomiting and abdominal pain were the most frequent clinical presentations among juveniles and adults respectively. There was no difference in gender distribution (F: 53.16% vs M: 46.84%), and the cystic gastric duplications were the most common type of the gastric duplications (87.04%). More than half (53.30%) of included cases were located in the greater curvature of stomach. Conclusions Gastric duplications could present with a wide spectrum of symptomatology, which might be misdiagnosed easily as other diseases. For cystic gastric duplications, the optimal treatment was a complete surgical removal. But conservative treatment might be an alternative strategy for tubular gastric duplications.
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Affiliation(s)
- Yang Li
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Chen Li
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Hao Wu
- Department of Gastroenterological Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Quan Wang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Zhi-Dong Gao
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xiao-Dong Yang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Ke-Wei Jiang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
| | - Ying-Jiang Ye
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
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5
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Díaz JC, Cardona-Núñez U, Sanz AM, Cortés A, Zuluaga M. Quiste de duplicación gástrico en paciente adulto: Reporte de caso y revisión de la literatura. REVISTA COLOMBIANA DE CIRUGÍA 2021. [DOI: 10.30944/20117582.756] [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
Introducción. Los quistes gástricos de duplicación son malformaciones congénitas muy infrecuentes del tracto gastrointestinal. Se definen como una lesión quística tapizada por epitelio gastrointestinal que comparte una capa de músculo liso con la pared gástrica. Se han propuesto diferentes teorías sobre su patogénesis, sin embargo, los eventos embriológicos que conducen a la malformación no han logrado ser dilucidados. Debido a su localización y presentación clínica, el diagnóstico se realiza con mayor frecuencia durante los primeros años de vida y existen pocos casos reportados en adultos, en quienes el hallazgo suele ser incidental.
Caso clínico. Se presenta el caso de una mujer de 65 años quien consultó por dolor abdominal crónico y síntomas digestivos inespecíficos. Por medio de Tomografía Axial Computarizada se evidenció una lesión quística en contacto con el páncreas y la pared gástrica. Se realizó exploración quirúrgica que, junto con los hallazgos histopatológicos, confirmó el diagnosticó de quiste de duplicación gástrico.
Discusión. Los quistes de duplicación gástrica son anomalías excepcionales que se localizan más frecuentemente en la curvatura mayor. Su tratamiento es quirúrgico y la confirmación del diagnóstico se realiza mediante la histología.
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6
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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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7
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Elhasan MEAB, Sirdab YA, Bakheit IA. 54-cm enteric duplication cyst in a 13-year-old female. Clin Case Rep 2018; 6:2099-2102. [PMID: 30455900 PMCID: PMC6230635 DOI: 10.1002/ccr3.1751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/08/2018] [Accepted: 07/09/2018] [Indexed: 11/11/2022] Open
Abstract
Enteric duplication cyst is a very rare condition, the affected individual may be asymptomatic. It has serious complications, on top of which is a malignant transformation tendency. To avoid these complications, resection of the duplication seems to be mandatory, even if it is an incidental finding.
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Affiliation(s)
- Mohamed Elghazali Ahmed Basheer Elhasan
- Assistant Professor of General SurgeryIbrahim Malik Teaching HospitalFaculty of Medicine‐University of KhartoumSudan
- MSc‐anatomy MRCS ‐part A‐ (Ed)General Surgery ResidentSudan Medical Specialization Board (SMSB)Khartoum StreetKhartoumSudan
| | - Younis A. Sirdab
- Assistant Professor of General SurgeryIbrahim Malik Teaching HospitalFaculty of Medicine‐University of KhartoumSudan
| | - Imad A. Bakheit
- FRCS (Ireland)Assistant Professor of General SurgeryFaculty of MedicineUniversity of KhartoumSudan
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8
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Abstract
Gastric duplication cysts are rare congenital anomalies, and malignant transformation has only been reported in 11 cases. A healthy 57-year-old woman presented with abdominal discomfort, and computed tomography revealed a 5.8 × 6.6 × 8.2 cm mass at the gastric fundus. On endoscopic ultrasound, the mass was mostly hypoechoic with anechoic cystic cavities arising from the submucosal layer. Fine-needle aspiration was suspicious for adenocarcinoma. Surgical pathology confirmed high-grade adenocarcinoma, clear cell cytology arising from a foregut duplication cyst. Endoscopic ultrasound is underutilized in the evaluation duplication cysts and should be considered in routine workup.
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9
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Endoscopic Treatment of Colonic Duplication Cyst: A Case Report and Review of the Literature. Case Rep Gastrointest Med 2018; 2018:6143570. [PMID: 29666719 PMCID: PMC5831991 DOI: 10.1155/2018/6143570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/04/2018] [Accepted: 01/16/2018] [Indexed: 02/07/2023] Open
Abstract
Colonic duplication cysts are a rare congenital abnormality commonly presenting before two years of age. In adults, it has been rarely reported, most often as an incidental finding. We report a case of 42-year-old female complaining of constipation and lower abdominal pain. Patient's CT scan of the abdomen showed a cystic lesion at hepatic flexure and the diagnosis was confirmed endoscopically using endoscopic ultrasound (EUS). The cyst was treated employing hot snare to expose the cyst cavity. On our literature search, there have been no reported cases of colonic duplication cyst treated endoscopically. We here discuss incidence, diagnosis, characteristics, and treatment of duplication cysts with special emphasis on endoscopic therapy.
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10
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Abdalkader M, Al Hassan S, Taha A, Nica I. Complicated Gastric Duplication Cyst in an Adult Patient: Uncommon presentation of an uncommon disease. J Radiol Case Rep 2017; 11:16-23. [PMID: 29299102 DOI: 10.3941/jrcr.v11i8.3124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Gastric duplication cyst is a very rare congenital anomaly accounting up to 4% of all gastrointestinal tract duplications. It is a quite rare anomaly in adults, the majority of the cases are diagnosed in the neonatal period. Gastric duplication cysts are usually asymptomatic or they do present with non-specific symptoms. They are usually discovered incidentally during endoscopy or laparotomy or very rarely after getting complicated. We describe herein, along with literature review, a case of an adult patient who presented with abdominal pain and bloody vomiting and turned out to have a gastric duplication cyst complicated by internal bleeding.
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Affiliation(s)
| | - Sacha Al Hassan
- Department of Pediatrics, Lebanese University, Beirut, Lebanon
| | - Alaa Taha
- Department of Gastroenterology, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Irina Nica
- Department of Radiology, Cliniques Universitaires Saint Luc, Brussels, Belgium
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11
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Gupta A, Chakaravarthi K, Pattnaik B, Kaman L. Duplication cyst of ileum presenting as acute intestinal obstruction in an adult. BMJ Case Rep 2016; 2016:bcr-2016-214775. [PMID: 27758850 DOI: 10.1136/bcr-2016-214775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Duplication cysts occur because of congenital aberration during gut development. They are commonly diagnosed during infancy and rarely during adulthood. We present an adult male who presented to surgical emergency with acute intestinal obstruction. Intraoperatively, this patient was found to have a non-communicating duplication cyst of ileum causing proximal obstruction. The involved segment of the small bowel was resected and a divided loop ileostomy was created.
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Affiliation(s)
| | | | | | - Lileswar Kaman
- Department of General Surgery, PGIMER, Chandigarh, Chandigarh, India
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12
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Yadav KS, Sali PA, Bhole B, Tampi C, Mehta H. Ileal duplication cyst in the elderly complicated by appendicitis: A rare case report and review of literature. Int J Surg Case Rep 2016; 27:24-27. [PMID: 27522400 PMCID: PMC4987508 DOI: 10.1016/j.ijscr.2016.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/18/2016] [Accepted: 08/02/2016] [Indexed: 11/24/2022] Open
Abstract
Duplication cysts seen commonly in the pediatric population is a rare entity in the elderly. Surgical resection is necessary due to possible complications. Laparoscopic management aids early recovery and minimum morbidity. Introduction Gastrointestinal duplication cysts are rare, generally found in infants and young adults. Adult presentation is rare. Presentation of the case We present an elderly lady who presented with right iliac fossa pain. Imaging showed a terminal ileal duplication cyst. Laparoscopic right hemicolectomy was done. Histopathology confirmed ileal duplication cyst with reactive appendicitis. Discussion Surgical resection is deemed appropriate management due to known complications like obstruction, hemorrhage, perforation and malignant degeneration. Resection of only the cyst is adequate in completely isolated cases. However, others require resection of adjoining small bowel. Conclusion We highlight the rare occurrence in elderly and its management laparoscopically.
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Affiliation(s)
- Kamal S Yadav
- Dept. of Surgical Gastroenterology, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Priyanka A Sali
- Dept. of Surgical Gastroenterology, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Bhushan Bhole
- Dept. of Surgical Gastroenterology, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Chandralekha Tampi
- Dept. of Histopathology, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
| | - Hitesh Mehta
- Dept. of Surgical Gastroenterology, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra West, Mumbai 400 050, India.
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13
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Gastrointestinal Stromal Tumor Arising From a Gastric Duplication Cyst. ACG Case Rep J 2016; 3:175-7. [PMID: 27144196 PMCID: PMC4843148 DOI: 10.14309/crj.2016.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/17/2015] [Indexed: 01/30/2023] Open
Abstract
Gastric duplication cysts (GDC) are rarely diagnosed in adults, but previous cases have been associated with malignancy. We present a case of gastrointestinal stromal tumor (GIST) arising from a GDC in a 71-year-old woman who presented with 3 years of early satiety, anorexia, abdominal distention, and weight loss. Abdominal CT showed a 9.3 x 5.2 x 9.5-cm well-circumscribed cystic mass arising 3 cm above the gastroduodenal junction. The cyst was resected, and histopathology was consistent with GDC. Future studies are needed to clarify the malignant potential of GDC and the molecular pathways for its development.
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14
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A Case Report and Review of the Literature of Adult Gastric Duplication Cyst. Case Rep Surg 2015; 2015:240891. [PMID: 26090260 PMCID: PMC4454723 DOI: 10.1155/2015/240891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 05/14/2015] [Indexed: 01/15/2023] Open
Abstract
Gastrointestinal (GI) duplication cysts are a rare congenital disease. They may involve any level of the alimentary tract, but they most commonly involve the ileum, esophagus, and jejunum. Gastric duplication cysts represent approximately 4–8% of GI duplication cysts, the majority of which present in early childhood. We present a rare case of adult gastric duplication cyst in a 25-year-old female found to have abdominal mass on computed tomography imaging. There are several potential methods to diagnose gastric duplication cyst and treatment of choice is complete surgical resection.
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15
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Kim SM, Ha MH, Seo JE, Kim JE, Min BH, Choi MG, Lee JH, Kim KM, Choi DI, Sohn TS, Bae JM, Kim JJ, Kim S, Lee JH. Gastric duplication cysts in adults: a report of three cases. J Gastric Cancer 2015; 15:58-63. [PMID: 25861524 PMCID: PMC4389098 DOI: 10.5230/jgc.2015.15.1.58] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/09/2014] [Accepted: 10/10/2014] [Indexed: 12/31/2022] Open
Abstract
Gastric duplication cyst is a rare congenital anomaly of the gastrointestinal tract and is especially uncommon in adults. Most cases in adults are discovered incidentally on radiological examination or gastric endoscopy. Accurate diagnosis of these cysts before resection is difficult. Differential diagnoses are varied. Malignant transformation of a gastric duplication cyst is very rare. We present three cases of asymptomatic noncommunicating gastric duplication cysts in adults.
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Affiliation(s)
- Su Mi Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Man Ho Ha
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eun Seo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Eun Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Hoon Min
- Department of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min Gew Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Haeng Lee
- Department of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Mi Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Choi
- Department of Diagnostic Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Moon Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Jun Kim
- Department of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Ho Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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16
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Liu R, Adler DG. Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound. Endosc Ultrasound 2014; 3:152-60. [PMID: 25184121 PMCID: PMC4145475 DOI: 10.4103/2303-9027.138783] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 01/29/2014] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal tract duplication cysts are rare congenital gastrointestinal malformation in young patients and adults. They consist of foregut duplication cysts, small bowel duplication cysts, and large bowel duplication cysts. Endoscopic ultrasound (EUS) has been widely used as a modality for the evaluation and diagnosis of duplication cysts. EUS is the diagnostic tool of choice to investigate duplication cysts since it can distinguish between solid and cystic lesions. The question of whether or not to perform EUS-fine needle aspiration (EUS-FNA) on a lesion suspected of being a duplication cyst is controversial as these lesions can become infected with significant consequences, although EUS-FNA is often required to obtain a definitive diagnosis and to rule out more ominous lesions. This manuscript will review the literature on duplication cysts throughout the body and will also focus on the role of EUS and FNA with regards to these lesions.
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Affiliation(s)
- Roy Liu
- Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, Salt Lake City, Utah, USA
| | - Douglas G Adler
- Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, Salt Lake City, Utah, USA
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Kang HJ, Jang SJ, Park YS. Adenocarcinoma arising in gastric duplication cyst. KOREAN JOURNAL OF PATHOLOGY 2014; 48:159-61. [PMID: 24868230 PMCID: PMC4026808 DOI: 10.4132/koreanjpathol.2014.48.2.159] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/16/2013] [Accepted: 06/18/2013] [Indexed: 12/15/2022]
Affiliation(s)
- Hyo Jeong Kang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se Jin Jang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Soo Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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18
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Unilateral pulmonary agenesis and gastric duplication cyst: a rare association. Case Rep Pediatr 2013; 2013:608706. [PMID: 23844300 PMCID: PMC3703420 DOI: 10.1155/2013/608706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/11/2013] [Indexed: 11/29/2022] Open
Abstract
Lung agenesis and gastric duplication cysts are both rare congenital anomalies. Gastric duplication cysts can present with nausea, vomiting, hematemesis, or vague abdominal pain. Unilateral pulmonary agenesis can present with respiratory distress which usually occurs due to retention of bronchial secretions and inflammations. We report the unique case of right pulmonary agenesis associated with gastric duplication cyst.
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19
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Multiple duplication cysts diagnosed prenatally: case report and review of the literature. Pediatr Surg Int 2013; 29:397-400. [PMID: 23371299 DOI: 10.1007/s00383-012-3231-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2012] [Indexed: 02/07/2023]
Abstract
Enteric duplication cysts (EDC) are typically solitary lesions that occur throughout the alimentary tract. Postnatal diagnosis is often prompted when complications occur from bleeding, obstruction, or infection. We present a case of multiple EDC diagnosed prenatally, managed with prenatal and neonatal follow-up and resection in infancy. Prenatal detection allowed for optimal management prior to the development of symptoms or complications.
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20
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Gastric duplication cyst: a rare congenital disease often misdiagnosed in adults. Case Rep Gastrointest Med 2013; 2013:850967. [PMID: 23476831 PMCID: PMC3583063 DOI: 10.1155/2013/850967] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 01/14/2013] [Indexed: 01/18/2023] Open
Abstract
Gastrointestinal duplication is a rare congenital disease which affected more commonly the ileum, while the stomach is rarely involved. Generally diagnosed in paediatric or young age, it could be difficult to suspect a gastrointestinal duplication in adults. Herein, we report a 55-year-old male with a gastric duplication cyst found on routinely checkup for chronic hepatitis and first misdiagnosed as a gastrointestinal stromal tumor (GIST); we also discuss its embryology.
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21
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Infected completely isolated enteric duplication cyst management with percutaneous drainage and surgical excision after retreat of infection: a case report. Case Rep Surg 2013; 2013:108126. [PMID: 23476873 PMCID: PMC3580896 DOI: 10.1155/2013/108126] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/09/2013] [Indexed: 01/07/2023] Open
Abstract
Duplication cysts (DCs) of alimentary tract are rare congenital malformations. They are firmly attached to the wall of the gastrointestinal tract and they are supplied by surrounding mesenteric blood vessels. More than 80% of cases occur before the age of two years and only a minority of cases present in adulthood. “Completely isolated duplication” of the alimentary tract is an extremely rare variety of gastrointestinal duplications. They have gastrointestinal epithelial and wall characteristics without an anatomic association with the alimentary tract. Their main characteristic is that they have their own blood supply. A 20-year-old male was admitted to our department with symptoms persisting for a period of one week prior to admission, which included abdominal pain, fever, and a palpable abdominal mass. CT revealed an unexplained intraperitoneal abscess. This case represents a rare clinical example of infected isolated duplication cyst managed with percutaneous drainage and surgical excision of the cyst 3 weeks later. To the best of our knowledge, this is the first reported case to use this approach.
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22
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Papanikolaou IS, Triantafyllou K, Kourikou A, Rösch T. Endoscopic ultrasonography for gastric submucosal lesions. World J Gastrointest Endosc 2011. [PMID: 21772939 DOI: 10.4253/wjge.v3.i5.862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Gastric submucosal tumors (SMTs) are a rather frequent finding, occurring in about 0.36% of routine upper GI-endoscopies. EUS has emerged as a reliable investigative procedure for evaluation of these lesions. Diagnostic Endoscopic ultrasonography (EUS) has the ability to differentiate intramural tumors from extraluminal compressions and can also show the layer of origin of gastric SMTs. Tumors can be further characterized by their layer of origin, echo pattern and margin. EUS-risk criteria of their malignant potential are presented, although the emergence of EUS-guided fne needle aspiration (EUS-FNA) has opened new indications for transmural tissue diagnosis and expanded the possibilities of EUS in SMTs of the stomach. Tissue diagnosis should address whether the SMT is a Gastrointestinal stromal tumour (GIST) or another tumor type and evaluate the malignant potential of a given GIST. However, there seems to be a lack of data on the optimal strategy in SMTs suspected to be GISTs with a negative EUS-FNA tissue diagnosis. The current management strategies, as well as open questions regarding their treatment are also presented.
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Affiliation(s)
- Ioannis S Papanikolaou
- Ioannis S Papanikolaou, Anastasia Kourikou, Konstantinos Triantafyllou, Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, University of Athens, Athens 12462, Greece
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23
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Papanikolaou IS, Triantafyllou K, Kourikou A, Rösch T. Endoscopic ultrasonography for gastric submucosal lesions. World J Gastrointest Endosc 2011; 3:86-94. [PMID: 21772939 PMCID: PMC3139278 DOI: 10.4253/wjge.v3.i5.86] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Revised: 05/03/2011] [Accepted: 05/05/2011] [Indexed: 02/05/2023] Open
Abstract
Gastric submucosal tumors (SMTs) are a rather frequent finding, occurring in about 0.36% of routine upper GI-endoscopies. EUS has emerged as a reliable investigative procedure for evaluation of these lesions. Diagnostic Endoscopic ultrasonography (EUS) has the ability to differentiate intramural tumors from extraluminal compressions and can also show the layer of origin of gastric SMTs. Tumors can be further characterized by their layer of origin, echo pattern and margin. EUS-risk criteria of their malignant potential are presented, although the emergence of EUS-guided fne needle aspiration (EUS-FNA) has opened new indications for transmural tissue diagnosis and expanded the possibilities of EUS in SMTs of the stomach. Tissue diagnosis should address whether the SMT is a Gastrointestinal stromal tumour (GIST) or another tumor type and evaluate the malignant potential of a given GIST. However, there seems to be a lack of data on the optimal strategy in SMTs suspected to be GISTs with a negative EUS-FNA tissue diagnosis. The current management strategies, as well as open questions regarding their treatment are also presented.
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Affiliation(s)
- Ioannis S Papanikolaou
- Ioannis S Papanikolaou, Anastasia Kourikou, Konstantinos Triantafyllou, Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, University of Athens, Athens 12462, Greece
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Unusual noncommunicating isolated enteric duplication cyst in adults. Gastroenterol Res Pract 2011; 2011:323919. [PMID: 21687617 PMCID: PMC3113256 DOI: 10.1155/2011/323919] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Accepted: 03/10/2011] [Indexed: 12/14/2022] Open
Abstract
Duplication cysts are rare gastrointestinal congenital abnormalities and can occur anywhere within the gastrointestinal tract. Duplication cysts are firmly attached to or share the wall of the alimentary tract and have a common blood supply with the adjacent segment of the bowel. Completely isolated duplication cysts are an extremely rare variety of gastrointestinal duplications with their own exclusive blood supply, and they do not communicate with the intestine. These cysts are usually diagnosed during early childhood, and very rarely detected in adults, mostly incidentally, due to a lack of symptoms. A 28-year-old male was admitted to our hospital with a chief complaint of lower abdominal pain and distention and a palpable mass for 1 month. Based upon computed tomography and sonographic findings, a small bowel duplication cyst was tentatively diagnosed. The cyst had no connection to the gastrointestinal tract. Herein we report the case of a noncommunicating isolated ileal duplication cyst in an adult. Resection of the cyst was performed safely without requiring bowel resection.
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