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Background: Duodenal duplication cysts are rare gastrointestinal tract malformations. Most patients experience symptom onset in the first decade of life. This review aims to examine clinical presentation, management strategies and outcomes of duodenal duplication cysts in childhood. Methods: A Pubmed/Medline (http://www.ncbi.nlm.nih.gov/pubmed/) search in October 2019 for articles published since 1999 using the keywords “duodenal duplication cyst,” “child” and “newborn” was carried out. Clinical symptoms, complications, diagnostic examinations, treatment options and outcomes were analyzed and tabulated. Results: There were 41 citations in the literature providing adequate descriptions of 45 cases of duodenal duplication cysts. The age of presentation ranged from newborn to 18 years. The median interval between initial presentation and definitive diagnosis and treatment was 17 months (range: 2 months to 12 years). Overall, 67% of cases presented with abdominal pain, and 43% were complicated with pancreatitis. Different surgical and endoscopic therapeutic strategies were reported. Conclusions: Duodenal duplication cysts may be associated with life-threatening complications and/or recurrent symptoms, impairing quality of life. Early recognition of patients who demonstrate suggestive signs and symptoms is important to ensure success of treatment. This review may be useful to highlight the main diagnostic aspects and limit the risk of a delayed diagnosis.

Background: Duodenal duplication cysts (DDCs) are rare congenital anomalies typically manifesting during childhood. Clinical manifestations are uncommon in adulthood. DDCs were classically treated surgically, but endoscopic treatment has been increasingly reported. Endoscopic cyst marsupialization establishes a communication between the cyst cavity and the duodenal lumen so that the cystic content can be drained continuously into the duodenum. We herein describe two cases of symptomatic DDCs diagnosed in adulthood and submitted to endoscopic marsupialization using different techniques and devices. Case Summary: Case 1: A 23-year-old female patient was admitted with the diagnosis of acute pancreatitis. Endoscopic ultrasound revealed a 35-mm duodenal subepithelial lesion whose proximal limit was immediately distal to the ampulla of Vater and filled with fluid and calcifications. Using a duodenoscope, deroofing of the lesion was made with a diathermic snare. Pathology confirmed the diagnosis of DDC. Case 2: A 41-year-old female, submitted to laparoscopic cholecystectomy 1 month earlier due to suspected lithiasic acute pancreatitis, was admitted due to suspicion of iatrogenic biliary fistula. An endoscopic retrograde cholangiopancreatography was performed and the bile leak was treated. Immediately distal to the papillary orifice, a 20-mm subepithelial lesion was also detected. A biopsy forceps was used to fenestrate its wall, allowing the exit of mucous fluid and stones, and a sphincterotome was used to expand the incision. No recurrence was documented in both cases. Conclusion: These cases highlight DDC as a potential cause for acute pancreatitis in adults and endoscopy as an easy treatment option.

We report the finding of a rare diagnosis of a duodenal duplication cyst (DDC) resulting in malignancy. Duplication cysts are rare entities in itself but less than 5% arise from duodenum. Our case represents a rare case, but high suspicion and early resection may have prevented associated complications.

BACKGROUND Duodenal duplications are rare congenital anomalies of the gastrointestinal tract. As the periampullary variant is much rarer, literature is scant and only few authors have reported their experience in diagnosis and treatment, particularly with operative endoscopy. CASE SUMARY To report our experience with the endoscopic treatment in a series of children with periampullary duodenal duplication cysts, focusing on the importance of obtaining an accurate preoperative anatomic assessment of the malformations. The pediatric periampullary duodenal duplication cyst literature is reviewed. We conducted a systematic review according to the PRISMA guidelines. The PubMed database was searched for original studies on “duodenal duplication”, “periampullary duplication” or “endoscopic management” published since 1990, involving patients younger than 18 years of age. Eligible study designs were case report, case series and reviews. We analyzed the data and reported the results in table and text. Fifteen eligible articles met the inclusion criteria with 16 patients, and analysis was extended to our additional 4 cases. Median age at diagnosis was 13.5 years. Endoscopic treatment was performed in 10 (50%) patients, with only 2 registered complications. CONCLUSION Periampullary duodenal duplication cysts in pediatric patients are very rare. Our experience suggests that an accurate preoperative assessment is critical. In the presence of sludge or stones inside the duplication, endoscopic retrograde cholangio-pancreatography is mandatory to demonstrate a communication with the biliary tree. Endoscopic treatment resulted in a safe, minimally invasive and effective treatment. In periampullary duodenal duplication cyst endoscopically treated children, long-term follow-up is still necessary considering the potential malignant transformation at the duplication site.

A neonate presenting with bilious vomiting requires prompt evaluation and diagnosis. In addition to the common causes of duodenal obstruction in this age group, duodenal duplication cysts need to be considered a part of the differential diagnosis. They are rare congenital occurrences that may present as bilious vomiting in a newborn. We report a case of a 22-days old baby boy presenting with abdominal distention and bilious vomiting, with later imaging revealing a cystic lesion in second and third part of the duodenum. The diagnosis of duodenal duplication cyst was further confirmed intraoperatively and in subsequent histopathological examination. The literature was reviewed and the best approach to diagnosis and management of duodenal duplication cyst in neonates is discussed.

Duodenal duplication cyst is not a common congenital anomaly and the pathophysiology may become very complicated if the cyst is situated at the ampulla of Vater. Here we report a very rare female case of duodenal duplication cyst at the ampulla of Vater, which caused acute pancreatitis due to massive protein plaques in the pancreatic duct. She had a past history of double duodenal atresia and underwent surgery as a neonate. The correct diagnosis could not be determined before the second operation at four years of age and the exact pathophysiology finally became apparent during the operation with a contrast medium study and duodenotomy. We discuss the complicated clinical features and diagnostic and treatment procedures before and during the operation.

We report the case of a 33-year-old man having presented the episodes of abdominal pains since a few months in 2014. He was handled by the anal-gesic and the anti spasmodic by his regular doctor. Symptoms in started up again with renewed vigor in February, 2015. The physical examination was normal. The complementary examinations must be known by the ultrasound the scanner and the magnetic resonance imaging which were in favour of a mass under person suffering from a liver complaint the normal blood balance assessment. The patient was exclusively operated by the way of coelioscopy and the anatomopathology examination of the operating room ended has a duplication duodenal. The operating consequences were simple until one year.

Choledochocele is a congenital abnormality of the biliary system, which characterized by a cystic dilatation of intramural segment of the distal common bile duct. Choledochocele manifests as cystic lesions in the duodenal lumen and resembles duodenal duplication cysts in imaging. We reported a patient with choledochocele. Magnetic resonance cholangiopancreatography showed a thin-walled sac in the duodenal cavity and a fine tubular structure connecting with the end of the common bile duct. Magnetic resonance cholangiopancreatography is a noninvasive and convenient technique in the diagnosis of choledochocele.

Introduction Duplication cyst of the alimentary tract is a rare congenital anomaly. Duodenal duplication cyst accounts for less than 5% overall. These entities rarely present in adults. They are often mistaken as choledochoceles. Management is most often complete excision, but it is individualized to the particular case. Case presentation A 22-year-old woman was admitted to our hospital with a history of intermittent colicky right hypochondrial pain not relieved by any medications for the past 3 months. Initially, she was given proton pump inhibitors, but her pain was not relieved. Further evaluation was done, and preoperative imaging showed a cyst in the second part of the duodenum. Magnetic resonance imaging revealed it as a choledochocele, but duodenal duplication cyst was kept in the differential diagnosis. Further ultrasound identified it to be a duplication cyst. After failed endotreatment, the patient was successfully managed with partial excision and marsupialization. Conclusion Duodenal duplication cyst is uncommon and rarely diagnosed in adults. Duplications in the duodenum should always be a part of the differential diagnosis, especially in cystic lesions. Ultrasonogram of the cyst might lead to the proper diagnosis. Surgery is the treatment of choice if endotherapy is not successful.

Duodenal duplication is an extremely rare congenital abnormality that occurs mostly in children. It represents only 2% to 12% of all gastrointestinal tract duplication. Its clinical presentation is highly variable and non-specific making the positive diagnosis very difficult. Imaging modalities can help to detect the lesions making the diagnosis more accurate before surgery. Here, we report a case of duodenal duplication revealed by chronic abdominal pain and treated by surgical resection in a 26-year-old man. Even in adults, it is necessary to evoke the diagnosis of duodenal duplication in patients with unexplained abdominal pain. Surgical resection remains the treatment of choice and endoscopic treatment is reserved for selected patients in whom surgery is difficult.

Duodenal duplication cysts are rare congenital anomalies that generally present with abdominal pain and vomiting or may have nonspecific symptoms. Surgical excision is the recommended treatment owing to possible complications, including malignancy. However, difficult locations like the periampullary region are problematic and major surgical procedures, for example, pancreaticoduodenectomy is necessary for total resection. These have a high complication rate resulting in a poor quality of life, especially in children and young adults. Here, we describe a case of duodenal duplication cyst managed by robotic (transduodenal) excision along with a brief review of the literature.

Gastrointestinal duplication cysts are infrequent congenital abnormalities. 2% to 12% of these abnormalities are localized in correspondence of the duodenum. This disease rarely remains asymptomatic until adulthood. We present a case of A 62-year-old woman with intermittent upper abdominal pain and nausea, describing the diagnostic and therapeutic route. Keywords: CT, Duodenal cyst, Duodenum, Endoscopic resection

Duodenal duplication cyst consists 6% of alimentary tract duplications and the prevalence is estimated to be less than 1 per 100,000 live births. This report is the first case report in a pediatric patient. A 19-month-old female patient was detected with a 5.2 cm sized intrahepatic cystic lesion in her follow-up ultrasonography examination for hydronephrosis. In her regular check-up, findings suggestive of food materials were detected inside the cyst. Further evaluation showed a 7 cm sized cyst located inside segment IV of the liver, connected to the duodenal bulb with a possibility of biliary communication. On exploration, duodenal duplication cyst with a 1.5 cm long stalk starting from the duodenal bulb to the hilum of the liver was identified. Due to its sophisticated location and possible communication with the biliary tree, Roux-en-Y cystojejunostomy was performed after resecting the stalk. The histopathologic finding of the stalk showed serosa, muscle, submucosa and duodenal mucosa which suggested its duodenal origin. The patient has been followed up without any complications for 7 months.

An 18-year-old woman with annular pancreas and duodenal duplication presented with recurrent acute pancreatitis and underwent a resection of duodenal duplication. However, the patient experienced recurrent abdominal pain after resection. Abdominal computed tomography and magnetic resonance imaging showed a dilatation of the peripheral pancreatic duct and stenosis and malformation of both the Wirsung's and Santorini's duct due to multiple stones. The modified puestow procedure was performed. The main pancreatic ducts in the body and tail were opened, and the intrapancreatic common bile duct was preserved. A Roux-en-Y pancreatico-jejunostomy was performed for reconstructing the pancreaticobiliary system after removing the ductal protein plug. The patient experienced no abdominal pain, no significant elevation of the serum amylase and lipase levels, and no stone formation during the 2 years of follow-up. This procedure is considered to be beneficial for pediatric patients with chronic pancreatitis due to annular pancreas and duodenal duplication.

Prompt preoperative diagnosis of duodenal duplication cyst is uncommon owing to its extreme rarity. The ideal treatment of intestinal duplication cyst is complete surgical excision, though in few cases, due to the proximity to the bilio-pancreatic duct, the complete excision is not possible. We herein present an infant presenting with bilious vomiting starting few days after birth. Ultrasonography and CT scan provided the diagnosis of the duplication cyst in relation to duodenum. A successful surgical management by a subtotal excision was done. Although duodenal duplication is seldom seen, it should be considered in differential diagnoses of upper gastrointestinal tract (GIT) occlusion.

Duodenal duplication cysts are rare congenital abnormalities. We report the case of a 16 year old female who presented with pancreatitis and duodenal intussusception and was subsequently diagnosed with heterotaxy, malrotation and a duodenal duplication cyst. She underwent open surgical management with successful excision of the cyst. The literature is reviewed and discussed.

Supernumerary ovary is a rare gynecological anomaly and is generally excised due to its potential malignant transformation. We report a case of a patient who was referred for excision of a probable duodenal duplication cyst that was subsequently identified as a paraduodenal supernumerary ovary. Pediatric surgery was consulted on an adolescent patient due to a presumed congenital anomaly of the intestinal tract based on imaging studies.

Highlights • Gastrointestinal tract duplication cysts as congenital malformations. • Duodenal duplication cyst extending into the posterior mediastinum. • It can be misdiagnosed even in surgery., Introduction Duodenal duplication is a rare congenital malformation. Although more frequent in childhood, it is rarely observed in adulthood. Preoperative diagnosis can be difficult. Presentation of case We report a case of 42 year-old woman with duodenal duplication cyst situated in the posterior mediastinum, who was misdiagnosed even after a primary surgery. Detailed diagnostic workup and a second operation was done. Discussion This article discusses the incidence of duodenal duplications, their types and clinical presentations, the radiologic and diagnostic features with different therapeutic options. Conclusion Duodenal and the other intestinal duplication cysts should be considered in the differential diagnosis of oral contrast enhanced intrathoracic lesions in thorocoabdominal computerised tomography imaging.