A completely isolated intestinal duplication cyst mimicking ovarian cyst torsion in an adult

Abstract

Intestinal duplications are rare congenital anomalies that can occur anywhere in the gastrointestinal tract. They are most commonly located in the ileum and are usually detected in infancy or early childhood. Duplicated segments are usually firmly attached to and sometimes communicate with the normal gastrointestinal tract. Rarely, intestinal duplications are completely isolated, thus not associated at all with any part of the gastrointestinal tract. Such duplications do not share a common blood supply with the adjacent normal intestinal segment, unlike the usual form of duplication, but rather have a separate vascular pedicle. Reports of completely isolated duplication cysts in adults are extremely rare; we found only five such reports in the English-language medical literature. Here, we report a case of a completely isolated duplication cyst 12 cm long in an adult female. The cyst had no connection to any part of the intestinal tract and had a dedicated vascular pedicle.

Keywords: Adult; Congenital abnormalities; Cysts; Digestive system; Duplication.

Figure 1

A contrast-enhanced coronal image of computed tomography reveals a well-circumscribed and poorly attenuated dumbbell-shaped mass exhibiting peripheral enhancement and a trilaminar appearance in the pelvic cavity.

Figure 2

Gross findings of the resected mass. The 12-cm-long cystic mass has a smooth pinkish outer surface (A), and the cavity is uniloculated and incompletely septated (B).

Figure 3

Microphotographs of the cystic wall. The wall consists of mucosa, submucosa, muscle layers, and serosa (A, HE stain, × 10), with regions of gastric-type mucosa containing oxyntic glands (B, HE stain, × 100).