Diagnosis and surgical management of a rare case of duodenal duplication cyst in a neonate: Case report and literature review

Abstract

Introduction and importance: Duodenal duplication cysts are a rare subtype of alimentary tract duplications cysts, consisting of 7 % of all the duplications. The clinical presentation is variable, depending on the size, location and mass effect. Most duodenal duplication cysts abut the second or third portion of the native duodenum. The standard treatment of choice for symptomatic enteric duplication cysts is complete surgical removal. In our case, by examining the abdomen, ectopic pancreatic tissue was found on the wall of the transverse colon, along with Meckel's diverticulum, 50 cm from the ileocecal junction.

Case presentation: We present a newborn case presented to the hospital with a history of abdominal mass with jaundice. Abdominal ultrasonography and CT scan show the presence of a cystic mass without specifying its exact source. By opening the abdomen, it was found at the expense of the duodenum, and it was excised and On histopathological analysis, a duodenal duplication cyst was diagnosed. The literature was reviewed and the approach to duodenal duplication cyst in neonates is discussed.

Clinical discussion: Duodenal duplication cysts are rare, even so should be taken into consideration when a mass is found. A thorough imaging investigation is crucial in establishing the diagnosis along with histopathology.

Conclusion: When diagnosing a Duodenal duplication cysts, the cyst must be completely removed because potential risk of malignant transformation.

Keywords: Case report; Duodenal duplication cyst; Neonate; Pediatric surgery.

Fig. 1

A: CT/cross coronal view of the Abdominal showing A cyst of 5 ∗ 5 cm in size with liquid content appears without adhesion to the liver or gallbladder and is located near the stomach. B: CT/cross axial view, showing A cyst without adhesion to the liver and reaches the right kidney without adhesion with it.

Fig. 2

A: Intraoperative image prior to excision, showing the cyst, with the blue arrow indicating the cyst and the green arrow indicating the duodenum. B:: Intraoperative image, showing the cyst after it has opened and the cavity within it has been viewed. C: An intraoperative image showing ectopic pancreatic tissue on the wall of the transverse colon. D: An intraoperative image showing Meckel's diverticulum.

Fig. 3

A: Histopathological analysis of the resected mass, Low-light view of the muscular layers in the cyst wall and the lining epithelial cells. B: Histopathological analysis of the resected mass, High-resolution view of the mucosa of the duplication cyst (atrophic duodenal mucosa consisting of villi and crypts with Brunner glands).