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Clinical Image
1 (
2
); 103-104
doi:
10.25259/WJWCH_22_2022

Communicating tubular ileal duplication cyst

Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
Corresponding author: Arka Banerjee, Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India. arkabanerjee6989@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Bendre PS, Banerjee A. Communicating tubular ileal duplication cyst. Wadia J Women Child Health 2022;1(2):103-4.

A six year old boy presented with right iliac fossa pain and was found to have a palpable lump in the right lower quadrant. Ultrasound showed a complex cystic mass in the right lower abdomen, raising the suspicion of an appendicular lump. Surgical exploration confirmed the presence of a tubular duplication cyst of the ileum, which was resected succesfully.

Enteric duplication cysts (EDCs) are seen in 0.2% of children (1 in 4500 live births) and show slight male preponderance.[1] Frequently observed in the terminal ileum, EDCs have a gastrointestinal (GI) mucosal lining (ectopic gastric tissue in 20–30%), a layer of smooth muscle tissue, and a common blood supply with the GI tract [Figure 1]. EDCs characteristically arise from the mesenteric border of the intestine and can be cystic (Type 1 seen in 79% of cases) or tubular (Type 2 seen in 21% of cases).[2] Prenatal ultrasound can identify around 20–30% of EDCs. About 80% of EDCs present within first 2 years of life with abdominal pain, vomiting and abdominal distension, asymptomatic palpable mass or rectal bleeding. Ultrasonography demonstrates a hollow structure with anechoic content, an intimal connection with the nearby intestine (“Y-configuration” of the common muscular wall), and “gut sign” (hyperechoic mucosa and hypoechoic smooth muscular tissue). Surgical treatment entails complete excision with closure of defect or segmental resection with anastomosis.

Figure 1:: (a) Ileal duplication cyst in a 6 year-old boy with palpable lump in the right lower quadrant (b) Surgical exploration confirmed the presence of a tubular EDC with well-developed communication with the ileal loop.

Declaration of patient consent

Patient’s consent not required as patient’s identity is not disclosed or compromised.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , , , , . Cysts of gastrointestinal origin in children: Varied presentation. Pediatr Gastroenterol Hepatol Nutr. 2017;20:94-9.
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  2. , , , , , , et al. Enteric duplication cysts in children: A single-institution series with forty patients in twenty-six years. World J Surg. 2017;41:620-4.
    [CrossRef] [PubMed] [Google Scholar]

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