Cecal duplication cyst presenting with acute abdomen: a case report

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Abstract

Cecal duplication cyst is a rare congenital malformation with a few reported adult cases. We present a 23-year-old man who presented with low-grade fever, constipation, and right lower quadrant pain for three days. An abdominal computed tomography scan showed a cystic mass of 8.8x7.5x6 cm adjoining to the posterior wall of the cecum. The patient underwent abdominal laparotomy, and a right hemicolectomy was performed with resection of the duplication cyst. The histopathological study confirmed the diagnosis of a non-communicating cecal duplication cyst. In conclusion, it is essential to include cecal duplication cyst in the differential diagnosis of the acute abdomen to guarantee the best treatment strategy.

Most cited references 11

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Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations.

Iain R J Macpherson (1993)

Gastrointestinal tract duplications are uncommon congenital abnormalities. By definition, they are located in or adjacent to the wall of part of the gastrointestinal tract, have smooth muscle in their walls, and are lined by alimentary tract mucosa. The lining mucosa is not necessarily that of the adjacent segment of the gastrointestinal tract. The only clinically important ectopic tissues are gastric mucosa and pancreatic tissue. Although ectopic gastric mucosa is found in duplications at all levels of the gastrointestinal tract, it is most prevalent (43%) in esophageal duplications. Peptic ulcer within this ectopic tissue can account for unusual, often misleading symptoms. Ectopic pancreatic tissue is most common (37%) in gastric duplications and is associated with pancreatitis and elevated amylase levels. Detection of associated vertebral anomalies is a helpful clue in the radiographic diagnosis of duplications. Barium studies usually reveal an intraluminal, intramural, or extrinsic mass, and ultrasonography (US) demonstrates its cystic nature. When US findings are inconclusive, computed tomography can be used to show the true nature, location, and extent of the lesion, as well as associated vertebral anomalies and possible other duplications. Technetium-99m pertechnetate scintigraphy provides definitive evidence of a duplication when it contains ectopic gastric mucosa and is particularly useful for suspected esophageal, duodenal, and small bowel lesions.

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Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound

Roy Liu, Douglas Adler (2014)

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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Gastrointestinal duplications.

P S Puligandla, L T Nguyen, D St-Vil … (2003)

The aim of this study was to review the presentations of gastrointestinal duplication (GID) and to assess the influence of prenatal diagnosis on treatment. Retrospective review of all GID at 2 pediatric hospitals from 1980-2002 was conducted. Seventy-three patients (M43:F30) were identified: 21 neonates, 28 infants (1 to 24 months), 15 children (1 to 10 years), 9 adolescents (>/=11 years). GID location by frequency was ileum (31.5%), ileocaecal valve (30.2%), duodenum (9.6%), stomach (8.2%), jejunum (8.2%), colon (6.8%), and rectum (5.5%). In neonates and infants, vomiting and distension were the most common presentations. Volvulus, caused by a duplication, occurred in 23.8% of neonates and caused the death of one neonate. Intussusception was identified in 10.9% of patients. In older children and adolescents, pain and vomiting were the most common associations. Six of these patients were being treated for Crohn's disease, with the diagnosis of duplication made at laparotomy. Eighteen patients had a prenatal diagnosis by ultrasound scan, with 77.2% of these asymptomatic after birth. Most prenatal diagnoses occurred after 1991 (77.8%). When comparing an earlier period (1980 to 1991; 29 patients) with the current (1992 to 2002; 44 patients), a greater proportion of the latter patients were asymptomatic (36.4 v 13.8%) and had a lower incidence of complications (volvulus/intussusception). GID can lead to life-threatening complications. Prenatal diagnosis should lead to expeditious postnatal investigation and treatment before the onset of symptoms or complications. GID in older children can mimic Crohn's disease. Laparoscopy/laparotomy should be considered in patients with atypical Crohn's disease or when the diagnosis of an intraabdominal mass is unclear. Copyright 2003 Elsevier Inc. All rights reserved.

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Contributors

Menawar Dajenah: https://orcid.org/0000-0001-9617-7019

Faisal Ahmed: https://orcid.org/0000-0001-7188-2715

Abdullatif Almohtadi: https://orcid.org/0000-0002-6347-1219

Fayed Al-Yousofy: https://orcid.org/0000-0001-7372-7540

Fawaz Mohammed: https://orcid.org/0000-0001-9256-3641

Journal

Journal ID (nlm-ta): Pan Afr Med J

Journal ID (iso-abbrev): Pan Afr Med J

Journal ID (publisher-id): PAMJ

Title: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

ISSN (Electronic): 1937-8688

Publication date (Electronic): 07 April 2022

Publication date Collection: 2022

Volume: 41

Electronic Location Identifier: 280

Affiliations

[1 ]Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, Yemen,

[2 ]Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen,

[3 ]Department of Radiology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen,

[4 ]Department of Gynecology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen,

[5 ]Department of Internal Medicine, School of Medicine, Ibb University of Medical Science, Ibb, Yemen,

[6 ]Department of Pathology, Faculty of Medicine, Taiz University of Medical Science, Taiz, Yemen,

[7 ]Department of Orthopedy, School of Medicine, Ibb University of Medical Science, Ibb, Yemen

Author notes

[& ] Corresponding author: Faisal Ahmed, Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen. fmaaa2006@ 123456yahoo.com

Article

Publisher ID: PAMJ-41-280

DOI: 10.11604/pamj.2022.41.280.33731

PMC ID: 9206177

SO-VID: ceb6ed3f-5f14-467a-8c74-ab309c85740f

License:

The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 11 February 2022

Date accepted : 01 April 2022

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Cecal duplication cyst presenting with acute abdomen: a case report

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Abstract

Most cited references 11

Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations.

Duplication cysts: Diagnosis, management, and the role of endoscopic ultrasound

Gastrointestinal duplications.

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