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Duodenal Duplication

Congenital Anomaly of Small Intestine Duodenum Duplication


Presentation

  • We report the case of a duodenal duplication cyst in an 81-year-old man who presented with gastrointestinal bleeding.[ncbi.nlm.nih.gov]
  • However, rarely it can also present in adulthood. It presents as a cystic or tubular mass, which can be communicating or non-communicating. Total excision is the ideal surgical procedure.[ncbi.nlm.nih.gov]
  • We present a case of a duodenal duplication cyst in a 43-year-old man presenting as melena. Initial gastroduodenoscopy and colonoscopy did not reveal any bleeding focus.[ncbi.nlm.nih.gov]
  • Abstract Duodenal duplications are rare congenital anomalies which can present with pancreatitis. A precise preoperative diagnosis is rarely possible.[ncbi.nlm.nih.gov]
  • The duodenum is the least common location for such an abnormality, which usually manifests as a spherical cyst-like structure that can present as mechanical bowel obstruction, biliary obstruction or an abdominal mass, among other presentations.[ncbi.nlm.nih.gov]
Left Flank Pain
  • In a few cases, ectopic gastric mucosa can appear and cause ulceration, bleeding and even perforation. 2,7 Our patient was asymptomatic and the cyst was firstly discovered while performing an ultrasonography for mild left flank pain.[ncbi.nlm.nih.gov]
Epigastric Tenderness
  • Physical examination revealed normal blood pressure, pulse and temperature with mild epigastric tenderness.[karger.com]
  • Abdominal examination revealed epigastric tenderness. Blood counts revealed signs of inflammation (white blood cells 14000 cells/mm 3 ). Biochemical investigations showed increased serum levels of amylase (450 U/L) and lipase (350 U/L).[saudisurgj.org]
Periumbilical Pain
  • The most common symptoms are periumbilical pain, vomiting, and gastrointestinal bleeding. Ulceration followed by perforation or hemorrhage can occur, especially in cases of the ectopic gastric mucosa.[njssjournal.org]
Regurgitation
  • Curvo-Semedo Department of Radiology, Hospitais da Universidade de Coimbra – Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, PT X close Abstract A 61-year-old male presented to the hospital with a 5-day history of epigastric pain, vomiting and regurgitation[jbsr.be]
Lacrimation
  • […] ampullary choledochocele, aspiration, bile, biliary duct, Bovie, cannulation, CBD, choledochal cyst, common bile duct, CT, duodenal duplication cyst, duodenal papilla, duodenotomy, endoscopic ultrasound, EUS, ex lap, exploration, exploratory laparotomy, lacrimal[sages.org]

Workup

  • Definitive treatment needed an extensive diagnostic workup and a second delicate operation.[ncbi.nlm.nih.gov]

Treatment

  • We present the successful endoscopic treatment of a symptomatic duodenal duplication cyst in a 9-year-old girl.[ncbi.nlm.nih.gov]
  • Endoscopic treatment by partial excision of the cyst with a polypectomy snare and sphincterotomy of the minor papilla was successful.[ncbi.nlm.nih.gov]
  • It is very important to discriminate between this rare anomaly and choledochocele as the treatment differs. Ultrasonography and ERCP are useful for the differential diagnosis. This rare anomaly is more often diagnosed in children.[ncbi.nlm.nih.gov]
  • This report describes both endoscopic diagnosis and treatment of a large periampullary duodenal duplication cyst associated with biliary obstruction in an adult patient.[ncbi.nlm.nih.gov]
  • Surgical treatment can be limited by the duplication's anatomical interrelationships with adjacent organs. Biliary sludge is an uncommon finding in the first year of life, and can readily regress spontaneously.[ncbi.nlm.nih.gov]

Prognosis

  • Now that antenatal findings are becoming increasingly sensitive in the detection of foetal anomalies, and parents need to be informed about the suspected pathology and its prognosis, we tried to determine, in the light of this case and a review of the[ncbi.nlm.nih.gov]
  • The prognosis is excellent with appropriate treatment The pancreas is an important organ of the digestive system.[dovemed.com]
  • […] intestine is the most frequent site of GI duplications, accounting for 44% of cases [3] Colonic duplications - These may be cystic or tubular; they represent 15% percent of duplications Rectal duplications - These represent up to 5% of GI duplications [9] Prognosis[emedicine.medscape.com]

Etiology

  • Enteric duplication cysts are rare congenital anomalies of unclear etiology. While they can occur anywhere in the gastrointestinal tract, they typically occur in the ileum or ileocecal region and very rarely in the duodenum.[ncbi.nlm.nih.gov]
  • PY - 2012/10 Y1 - 2012/10 N2 - Enteric duplication cysts are rare congenital anomalies of unclear etiology.[uncch.pure.elsevier.com]
  • Results A 67-year-old lady was referred to the GI clinic with a long history of iron-deficiency anemia since childhood and intermittent melena with unknown etiology.[academic.oup.com]
  • Gastrointestinal tract duplications: Clinical, pathologic, etiologic, and radiologic considerations. Radiographics. 1993, 13:1063-1080 Redondo-Cerezo E, Pleguezuelo-Díaz J, de Hierro ML, Macias-Sánchez JF, Ubiña CV, Martín-Rodríguez Mdel M et al.[ivyunion.org]
  • Whether a common etiology exists for both these anomalies is unclear.[jneonatalsurg.com]

Epidemiology

  • The literature on duodenal duplications, and their epidemiology, embryology and pathophysiology is reviewed.[ncbi.nlm.nih.gov]
  • The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly.[books.google.ro]
  • Epidemiology GI duplications are observed in 1 of every 4500 autopsies, predominantly in white males. Synchronous GI duplications occur in as many as 15% of patients.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • The literature on duodenal duplications, and their epidemiology, embryology and pathophysiology is reviewed.[ncbi.nlm.nih.gov]
  • According to previous reports [ 6, 7 ], we speculate that the pathophysiology of our case was as follows: (1) the antral mucosa in the duplication was isolated from its typically acidic environment, which led to the lack of hydrogen ion feedback inhibition[surgicalcasereports.springeropen.com]
  • The following are examples: Thoracoabdominal duplications - Vertebral anomalies (approximately 75%) Enteric cystic duplications - Intestinal atresias Tubular hindgut duplications - Genitourinary malformations Pathophysiology GI duplications are most frequently[emedicine.medscape.com]

Prevention

  • Retrospectively, after reviewing the literature on gall bladder duplications, we felt cholecystectomy should have been done to prevent future complications.[jneonatalsurg.com]
  • For relieving symptoms and preventing further complications, such as pancreatitis or malignant transformation, surgical resection of duodenal duplication cysts is indicated.[ncbi.nlm.nih.gov]
  • The anomalies are organized by anatomical system and presented in a consistent manner, including details of the clinical presentation, epidemiology, embryology, treatment and prevention for each anomaly.[books.google.ro]
  • However, if this is planned, one must determine whether gastric mucosa is present (with technetium scan); if so, it must be excised to prevent future ulceration.[emedicine.medscape.com]
  • Because the patient was not jaundiced, bile emptying from the cyst into the duodenum was sufficient and the ampulla prevented transmission of pressure from the filled cyst into the biliary tree.[pancreas.imedpub.com]

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