Clinical characteristics of gastrointestinal tract duplications in children: A single-institution series review

Abstract

Due to the various presentations of gastrointestinal tract duplications (GTD), diagnosing and management for this disease might be varied and difficult. We intend to improve the experiences for these difficult, in terms of the clinical presentations, diagnostic investigations, management.We reviewed recent literature and retrospectively analyzed 72 pediatric patients with enteric duplication. Diagnosis was confirmed by surgery and pathological examination for imaging characteristics and clinical and pathological features.The ages of patients ranged from one month to 12.5 years. The clinical presentations of the patients included 57 cases with abdominal pain, followed with nausea or vomiting, abdominal distension, etc. All of the patients were diagnosed by ultrasonography, and most of them presented as intra-abdominal cystic masses. Four cases were diagnosed with the cysts other than GTDs, like, mesenteric cyst, chledochal cyst and abscess, and so on. Computed tomography was performed on 65 patients. X-rays and barium meal showed the outline of the cyst structure, with intestinal displacement due to the pressure from the cyst. Among the 72 cases of enteric duplication, 45 were located with ileocecal area, 41 were ileal and 8 were colonic duplications.Enteric duplication is very rare in children and is prone to misdiagnosis. The preoperative diagnosis of enteric duplication can be improved through comprehensive analysis of various imaging exams and closely related clinical presentations.

Figure 1

Sonogram of a distal ileal duplication cyst. On tranverse view, an anechoic lesion with typical wall characteristics is seen-inner echogenic mucosal stripe and outer hypoechoic muscle layer (arrow).

Figure 2

Barium meal radiography of whole digestive tract study demonstrates a mass marked off by filling barium small intestine in fight inferior belly (arrow).

Figure 3

Abdominal CT scan with contrast. It shows a well circumscribed homogeneous cyst (Cy) pushing forward the posterior Ileum wall. The contrast visualized in the Ileum lumen (St) is not evident in the cyst (arrow).