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Esophageal Duplication

Cong Duplication of Esophagus


Presentation

  • A 32-year-old man presented acutely with a ruptured esophageal duplication cyst. This is a rare complication from an unusual congenital condition. The case describes his clinical presentation, radiological investigation and surgical management.[ncbi.nlm.nih.gov]
Feeding Difficulties
  • : A rare cause of biphasic stridor and feeding difficulty", keywords "Duplication cyst, Esophageal cyst, Feeding difficulty, Stridor", author "Moulton, {Marlene St Joan} and Christopher Moir and Jane Matsumoto and Thompson, {Dana M[scholars.northwestern.edu]
  • These should be recognized as a cause of respiratory distress in infants and are usually associated with feeding difficulties. We report 2 such cases of esophageal duplication cyst in infants, causing acute respiratory distress.[ncbi.nlm.nih.gov]
  • Kawahara et al. describe a case of an esophageal duplication cyst that was identified at 30 weeks gestation and managed surgically when the infant was 35 days of age because of stridor and feeding difficulties.[humpath.com]
Intermittent Fever
  • Here, we describe a 3-year-old Han Chinese boy afflicted with intermittent fever of acute onset and dry cough.[ncbi.nlm.nih.gov]
Stridor
  • : A rare cause of biphasic stridor and feeding difficulty", keywords "Duplication cyst, Esophageal cyst, Feeding difficulty, Stridor", author "Moulton, {Marlene St Joan} and Christopher Moir and Jane Matsumoto and Thompson, {Dana M[scholars.northwestern.edu]
  • Kawahara et al. describe a case of an esophageal duplication cyst that was identified at 30 weeks gestation and managed surgically when the infant was 35 days of age because of stridor and feeding difficulties.[humpath.com]
  • Esophageal duplication cyst: a rare cause of biphasic stridor and feeding difficulty. Int J Pediatr Otorhinolaryngol. 2005;69(8):1129–33. View Article PubMed Google Scholar Sharma KK, Ranka P, Meratiya S.[surgicalcasereports.springeropen.com]
  • Cases of oesophageal duplication cysts in adults have also been reported in the literature. 7,8 A recently reported case of oesophageal duplication cyst was diagnosed at 6 months of age with the presentation of "inspiratory stridor and dyspnoea." 9 Another[jpma.org.pk]
  • EDCs are often an incidental finding during routine radiological investigations. 1 Most of patients are asymptomatic prenatally and after birth, although 80% of them develop symptoms during childhood. 10 Cough, stridor, feeding difficulties, and chest[journals.lww.com]
Dyspnea
  • A 18-yr. old man, who had suffered from dry cough and mild dyspnea, was admitted because of an incidentally detected chest mass.[ncbi.nlm.nih.gov]
  • […] epithelial inclusion cysts. esophageal atresia congenital lack of continuity of the esophagus, commonly accompanied by tracheoesophageal fistula, and characterized by accumulations of mucus in the nasopharynx, gagging, vomiting when fed, cyanosis and dyspnea[medical-dictionary.thefreedictionary.com]
  • If the patient develops dyspnea and pneumoderma during or after this procedure, a chest radiogram or thoracoabdominal CT should be taken for diagnostic purposes.[giornalechirurgia.it]
Sputum
Inspiratory Stridor
  • Cases of oesophageal duplication cysts in adults have also been reported in the literature. 7,8 A recently reported case of oesophageal duplication cyst was diagnosed at 6 months of age with the presentation of "inspiratory stridor and dyspnoea." 9 Another[jpma.org.pk]
Tracheal Deviation
  • Ultrasonography, computed tomography, and MRI revealed tracheal deviation in 19 cases. Respiratory distress was caused by tracheal compressive deformation and deviation in 12 cases (60 %), three of which needed tracheal intubation.[surgicalcasereports.springeropen.com]
Dysphagia
  • We report a unique case of esophageal duplication cyst in a 52-year-old woman with rapidly progressing chest pain and dysphagia. The cyst was found to share, in part, a remarkably inflammatory and edematous inner lining with the esophagus.[ncbi.nlm.nih.gov]
  • Gastroenterol Res. 2016;9(4-5):79-82 doi: Keywords Duplication cyst; Submucosal tumor; Dysphagia Full Text: HTML PDF[gastrores.org]
Vomiting
  • […] epithelial-lined cysts and esophageal duplication, which is an embryologic duplication of a portion of the muscle and submucosa of the esophagus without epithelial duplication. 48 year-old male, with no relevant history, was transferred in our department with vomiting[ncbi.nlm.nih.gov]
  • An otherwise healthy 23-year-old man presented with a 3-week history of difficulty swallowing solid food and associated vomiting. He reported no history of respiratory symptoms or weight loss.[nejm.org]
  • Presentation of large duplication cysts usually occurs in the newborn or infant, with symptoms referable to pressure on the adjacent lung or esophagus, leading to: respiratory difficulties dysphagia vomiting Smaller cysts can be asymptomatic and are usually[radiopaedia.org]
  • In adults, they can present with a variety of symptoms ranging from dysphagia, chest pain, epigastric discomfort, and vomiting to more serious complications including infections, hemorrhage, and ulcerations.[gastrores.org]
  • […] esophagorespiratory fistulae, diverticula, epithelial inclusion cysts. esophageal atresia congenital lack of continuity of the esophagus, commonly accompanied by tracheoesophageal fistula, and characterized by accumulations of mucus in the nasopharynx, gagging, vomiting[medical-dictionary.thefreedictionary.com]
Regurgitation
  • […] chlorinated naphthalene poisoning. esophageal motility disorders esophageal neoplasm very rare except for papilloma and fibropapilloma; causes chronic esophageal obstruction. esophageal obstruction acute obstruction is manifested by inability to swallow, regurgitation[medical-dictionary.thefreedictionary.com]
  • This dysfunction of the esophagus can lead to difficulty swallowing and frequent regurgitation of food.[massgeneral.org]
  • In some cases, these lesions can result in difficulty swallowing (dysphagia), food getting stuck in the esophagus, chest pain, or regurgitation of food. Some of these symptoms may ultimately cause weight loss.[nyp.org]
Left Flank Pain
  • Herein, we describe two cases of intra-abdominal EDCs: a 60-year-old man who was incidentally found to have a retro-duodenal cystic mass and a 50-year-old woman with a cystic lesion near the body and tail of her pancreas causing left flank pain.[ncbi.nlm.nih.gov]
  • Incidental at fundoplication Gastroesophageal junction 3.0 Laparoscopic resection, with fundoplication Martin et al [ 5 ] 2007 60 M Gastric outlet obstruction Retro-duodenal 10.0 10.0 Open resection Martin et al [ 5 ] 2007 50 F Left flank pain Inferior[wjgnet.com]
Neck Mass
  • Symptoms included respiratory distress and palpable neck mass. Computed tomography demonstrated cystic masses in the retropharyngeal space. Both patients underwent surgical resection of the cyst and the symptoms were relieved.[ncbi.nlm.nih.gov]

Workup

  • Postnatal workup showed a noncommunicating compressive cyst bound to the lower third of the native esophagus. He underwent its removal by transhiatal laparoscopy.[ncbi.nlm.nih.gov]
  • Several imaging studies for diagnostic workup were also needed. Radiological methods can be helpful in the diagnosis and localization of the disease.[e-ce.org]

Treatment

  • When diagnosis is made, treatment decisions are not always straight forward, although excision is frequently pursued. The current case describes this unique finding and presents laparoscopic excision as a safe treatment alternative.[ncbi.nlm.nih.gov]

Prognosis

  • MRI T1: low to intermediate signal intensity T2: high signal intensity Treatment and prognosis Surgical resection is the mainstay of management 8 . Prognosis tends to be very good as recurrence is rare 8 .[radiopaedia.org]
  • […] teratoma Treatment Nearly ¾ with cysts will become symptomatic, so they are usually resected Simple cysts are enucleated Duplication cysts are excised Complications Complication rates from surgery are very low Malignant degeneration is rare but reported Prognosis[learningradiology.com]
  • […] early as possible to avoid complications such as infection, mass effects, hemorrhage, rupture, or neoplastic degeneration. [2] The treatment of choice is complete surgical excision due to the possibility of degeneration and ease of removal. [2] The prognosis[ijccm.org]
  • After surgical excision, the prognosis is encouraging. As our patient received primary repair of BEF without knowledge of ED, and his symptoms disappeared, we did not conduct additional surgery for ED.[e-ce.org]
  • Prognosis If the entire cyst is excised, recurrence is rare. Morbidity is low. Overall, most patients do well, both in the short term and in the long term. Cioffi U, Bonavina L, De Simone M, Santambrogio L, Pavoni G, Testori A.[emedicine.medscape.com]

Etiology

  • Abstract Esophageal duplication and congenital esophageal stenosis (CES) may represent diseases with common embryologic etiologies, namely, faulty tracheoesophageal separation and differentiation.[ncbi.nlm.nih.gov]
  • Record : found Abstract : found Article : not found Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations. Gastrointestinal tract duplications are uncommon congenital abnormalities.[scienceopen.com]
  • View Article PubMed PubMed Central Google Scholar Macpherson RI: Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations. Radiographics. 1993, 13: 1063-1680.[cardiothoracicsurgery.biomedcentral.com]
  • The etiology of this entity is explained by several theories. 1–3 According to Bentley and Smith, gastrointestinal duplications occur as a consequence of a split notochord.[journals.lww.com]
  • Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations. Radiographics 1993;13:1063-1080. 10. Joyce AM, Zhang PJ, Kochman ML. Complete endoscopic resection of an esophageal duplication cyst (with video).[e-ce.org]

Epidemiology

  • Epidemiology: Children are born with duplication cysts but symptoms usually happen before age two. Occurs in about 1 in 4,500 live births.[eapsa.org]
  • Epidemiology Esophageal cysts are rare, [3, 2] but their true incidence is unknown. No large study has defined the true frequency of esophageal cysts in the United States or internationally.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiological examination revealed an EDC. The patient recovered well, without symptoms 6 months later. CONCLUSIONS: Overall, noninvasive imaging and diagnostic procedures may not be sufficient to define the exact location of an EDC.[ncbi.nlm.nih.gov]
  • Unlike others on this topic, this text demonstrates how the endoscope incorporates pathophysiology, diagnostic, and treatment modalities into endoscopic practice.[books.google.de]
  • Pathophysiological examination revealed an esophageal duplication cyst. We report a rare case of a symptomatic intra-abdominal esophageal duplication cyst in an adult.[wjgnet.com]
  • Pathophysiology Esophageal cysts develop from aberrant elements of the esophageal wall.[emedicine.medscape.com]

Prevention

  • Our results suggest that closing the esophageal muscle layer after removal of an esophageal duplication cyst may be indicated to prevent both complications and the need for reoperations. Copyright 2016 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
  • Special chapters, such as the Designing Clinical Research in Gastrointestinal Endoscopy, The Prevention of Infection Following Gastrointestinal Endoscopy, Complications of Peptic Ulcer Disease, and Credentialing for Gastrointestinal Endoscopy, help make[books.google.de]
  • The muscular edges of the esophagus should be approximated to prevent a pseudo-diverticulum after enucleation of the esophageal cyst. 11 Puncture and drainage of the cyst, guided by endoscopy or CT, can be the alternative option in patients with high[synapse.koreamed.org]
  • For this reason, surgical resection is indicated for all symptomatic lesions and is favored for asymptomatic cysts to prevent future complications.[humpath.com]

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