Gastric duplication cyst: rare cause of upper gastrointestinal bleeding in a young adult, with a review of literature

Duplication cyst along the alimentary canal is a congenital anomaly which is rare and usually incidentally found at endoscopy or radiological imaging. It can develop anywhere along the alimentary canal with only 4% occurrence in the stomach. Only few cases of gastric duplication cysts were reported to be symptomatic along with its complications. Diagnostic modalities include oesophageo-gastroduodenoscopy (OGDS), endoscopic ultrasound (EUS), computerized tomography (CT) scan and magnetic resonance imaging (MRI). However, the best option to confirm the diagnosis is complete resection of the lesion. We are reporting about a teenage girl whereby she presented with sudden episodes of hematemesis, which led to a syncopal attack. She also complained of intermittent central abdominal pain for a month prior to her presentation. Physical examination was unremarkable. However, her blood investigation showed a significant drop in hemoglobin. The patient had an endoscopy during which a submucosal lesion at the greater curvature was identified and the provisional diagnosis we had was a gastrointestinal stromal tumor (GIST). CT scan of the abdomen was also done showing an endoluminal cystic gastric lesion measuring approximately 2×2×2 cm. The lesion was confined to the stomach with no local infiltration of the adjacent structures. Decision was made to proceed with a laparoscopic wedge resection after outweighing the risk and benefits of surgery. Gastric duplication cyst is a rare anomaly. Despite its rarity, it should be included as a differential when we encounter a submucosal lesion due to its tendency for malignant transformation and other complications.

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Common bile duct perforation resulting from a gastric duplication cyst

Pediatric Surgery International ◽

10.1007/s00383-007-1950-6 ◽

2007 ◽

Vol 24 (4) ◽

pp. 459-461

Author(s):

Justin Bottsford ◽

John J. Meehan

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Duplication Cyst ◽

Gastric Duplication ◽

Gastric Duplication Cyst ◽

Bile Duct Perforation

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A Case of Intrathoracic Gastric Duplication Cyst Detected on Prenatal Ultrasound Examination

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/5346920 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Hisako Yagi ◽

Yoshino Kinjyo ◽

Yukiko Chinen ◽

Hayase Nitta ◽

Tadatsugu Kinjo ◽

...

Keyword(s):

Cesarean Section ◽

Cystic Lesion ◽

Mass Effect ◽

Posterior Mediastinum ◽

Duplication Cyst ◽

Elective Cesarean Section ◽

Uneventful Recovery ◽

Gastric Duplication ◽

Gastric Duplication Cyst ◽

Elective Cesarean

A 37-year-old (G4P3) woman was referred to our hospital at 32 weeks of gestation for the evaluation of a fetus with an intrathoracic cystic lesion. Ultrasonography and magnetic resonance imaging revealed that a fetal cystic lesion without a mucosal layer was located in the posterior mediastinum. These findings were consistent with a bronchogenic cyst. At 38 3/7 weeks of gestation, an elective cesarean section was performed because of her previous cesarean section. A female neonate without any external anomalies, weighing 2,442 g, with Apgar scores of 8 and 9, and requiring no resuscitation was born. Four weeks after delivery, the neonate was admitted because of respiratory distress due to mass effect. At right lateral thoracotomy, a 105 × 65 mm of solitary smooth-walled cyst containing serosanguineous fluid was found in the posterior mediastinum, which was excised completely. Histologic examination revealed the diagnosis of the mediastinal gastric duplication cyst. The neonate made an uneventful recovery. Accurate diagnosis is not necessary, but detection and continuous observation are logical. Although gastric duplication, particularly intrathoracic, is a rare pathology, it should be considered in the differential diagnosis of any intrathoracic cyst.

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Sarcomatoid Carcinoma Arising in a Gastric Duplication Cyst

ACG Case Reports Journal ◽

10.14309/crj.0000000000000584 ◽

2021 ◽

Vol 8 (5) ◽

pp. e00584

Author(s):

Mohamed A. H. Ahmed ◽

Kanchana Sanjeewani Liyanaarachchi ◽

Shaun R. Preston ◽

Madeleine Hewish ◽

Izhar N. Bagwan

Keyword(s):

Sarcomatoid Carcinoma ◽

Duplication Cyst ◽

Gastric Duplication ◽

Gastric Duplication Cyst

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Gastric antral duplication cyst: A case report

Paediatrica Indonesiana ◽

10.14238/pi61.5.2021.287-90 ◽

2021 ◽

Vol 61 (5) ◽

pp. 287-90

Author(s):

Kaniz Fathema ◽

MD. Benzamin ◽

Fahmida Begum ◽

Fahmina Khanam ◽

Md Mahamudul Hasan ◽

...

Keyword(s):

Weight Loss ◽

Alimentary Tract ◽

Pancreatic Cyst ◽

Clinical Course ◽

Duplication Cyst ◽

Ectopic Gastric Mucosa ◽

Gi Tract ◽

Gastric Duplication ◽

Gastric Duplication Cyst ◽

Matters Of Concern

Alimentary tract duplications may be symptomatic or may be discovered incidentally. They are named for the organ with which they are associated.1 Congenital gastrointestinal (GI) tract duplication cysts are commonly located in the ileum (53%), mediastinum (18%), colon (13%), stomach (7%), duodenum (6%), rectum (4%), or oesophagus (2%)2. A single theory is insufficient to explain all types of duplications.3 Children may present with symptoms like vomiting, abdominal pain, lumps, or weight loss.4 The presence of ectopic gastric mucosa and the potential for malignancy remain matters of concern.2 Surgical management is essential for these rare cysts.5 We encountered a Bangladeshi boy with a gastric duplication cyst (GDC) that was pre-operatively diagnosed as a pancreatic cyst. A variety of imaging modalities failed to indicate GDC before the operation. Here we present the clinical course of the case and discuss the difficulties and problems in diagnosing GDC.

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Gastric duplication cyst with localization in the pancreas in children

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic609 ◽

2020 ◽

Vol 10 (1) ◽

pp. 35-42

Author(s):

Yurii Yu. Sokolov ◽

Artem M. Efremenkov ◽

Aleksandr P. Zykin ◽

Elena L. Tumanova ◽

Zhanna R. Omarova ◽

...

Keyword(s):

Mucous Membrane ◽

Clinical Observation ◽

Abdominal Cavity ◽

Clinical Manifestations ◽

Duplication Cyst ◽

The Body ◽

Recurrent Bleeding ◽

Gastric Duplication ◽

Gastric Duplication Cyst ◽

Gastric Type

Introduction. Gastric duplication cyst is a rare clinical observation. More often, these cysts are localized in the fundus or body of the stomach and have a common muscle layers and blood supply. Even more rarely, duplication cysts are not anatomically connected to the stomach and are located in other parts of the abdominal cavity or in the retroperitoneal space. Cystic duplication of the gastrointestinal tract, which are localized in the pancreas, is extremely rare. The aim of the study is to demonstrate the possibility of using laparoscopy for this disease. Materials and methods. The paper describes three rare clinical observations of gastric duplication cyst topographically associated with the pancreas. In the first clinical observation, gastric duplication cyst was combined with mediastinal duplication cysts, an esophageal bronchial fistula, and extralobar pulmonary sequestrations. In the second observation, a duplication cyst had communication with the pancreatic duct system and was clinically manifested by recurrent bleeding. In the third case, a duplication cyst is diagnosed behind the body and tail of the pancreas. Results. In all cases, surgical treatment was carried out by the laparoscopic method, leading to complete recovery. Histological examination in all the described observations confirmed the gastric type of epithelium of the mucous membrane of the cysts. The article provides a review of the literature. Conclusion. Thus, the efficiency of laparoscopic interventions in children with gastric duplications topographically associated with the pancreas was demonstrated. The described rare clinical manifestations, a combination of defects, as well as the possible presence of heterotopy of the mucous membrane of the duplication cyst confirm the need for surgical correction of the disease.

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Use of endoscopic ultrasound to guide the diagnosis and endoscopic management of a large gastric duplication cyst

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(98)70304-9 ◽

1998 ◽

Vol 47 (1) ◽

pp. 76-79 ◽

Cited By ~ 16

Author(s):

Gregory M. Woolfolk ◽

Stephen A. McClave ◽

Whitney F. Jones ◽

Robin B. Oukrop ◽

Martin D. Mark

Keyword(s):

Endoscopic Ultrasound ◽

Duplication Cyst ◽

Endoscopic Management ◽

Gastric Duplication ◽

Gastric Duplication Cyst

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Gastric duplication cyst masquerading as a mucinous pancreatic cyst: case report and literature review

Annals of The Royal College of Surgeons of England ◽

10.1308/003588414x13824511649977 ◽

2014 ◽

Vol 96 (1) ◽

pp. 1-3 ◽

Cited By ~ 5

Author(s):

CE Bailey ◽

MB Fritz ◽

L Webb ◽

NB Merchant ◽

AA Parikh

Keyword(s):

Laparoscopic Distal Pancreatectomy ◽

Duplication Cyst ◽

Cystic Neoplasms ◽

Gastric Duplication ◽

Lower Quadrant ◽

Gastric Duplication Cyst ◽

Fluid Analysis ◽

Chronic Nausea ◽

Mucinous Cyst

Gastric duplication cysts are rare cystic neoplasms that are often difficult to distinguish from other entities. We describe a healthy 44-year-old woman who presented with acute right lower quadrant abdominal and flank pain as well as chronic nausea and constipation. Her physical examination was unremarkable but contrasted computed tomography revealed a 6cm cystic lesion between the stomach and body of the pancreas. Endoscopic ultrasonography and fluid analysis were consistent with a mucinous cyst with a markedly elevated fluid carcinoembryonic antigen level. The patient subsequently underwent a laparoscopic distal pancreatectomy, which was converted to an open procedure when the lesion was noted to be adherent to the coeliac axis. Intraoperative endoscopy revealed no abnormality. Final pathology revealed a gastric duplication cyst. The patient recovered well and was asymptomatic on follow-up. In this report, we discuss the incidence, natural history and management of this rare entity.

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