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Intestinal duplication in the tongue is a rare entity. Occurrence in the anterior part of the tongue is exceptional. We report an intestinal duplication in the tongue causing eating difficulties and discuss the accuracy of embryologic and histopathology knowledge as radiology. A transoral complete resection of the lesion was performed, without postoperative complications. There was no recurrence with a follow-up of 15 years.

A rare clinical case of an isolated intestinal duplication cyst in a 6-year-old child with unclear clinical picture of alimentary dyspepsia is described in the work. Surgical cyst laparoscopic removal resulted in convalescence. The article presents review of literature devoted to treatment of this pathology.

Background Isolated enteric duplication cyst is an intestinal duplication cyst found in a distant location from the intestinal tract and it is said to have its own blood supply. Meckel’s diverticulm is considered as an antimesenteric structure and has its own blood supply. However, there are some reported cases of Meckele’s diverticum in the mesenteric side. Ectopic pancreas may be found in both entities. Case presentation A 5-year-old girl presented with increasing abdominal pain around the umbilicus. On laboratory investigation serum pancreatic enzymes and C-reactive protein were elevated. Abdominal computed tomography (CT) revealed a normal pancreas but a cystic lesion in the mesentery of the ileum. A nodule with a marked enhancement was observed in the wall of the lesion. During the laparoscopy, the lesion was found at the root of the mesentery and was distant from the ileum. The lesion was resected suspecting an abscess. Pathologically, the wall of the lesion consisted of small bowel like tissue, and pancreatic tissue was seen beneath the mucosa. There were some post inflammatory changes in the pancreatic tissue. Retrospectively on thin slice enhanced CT, an independent blood supply was noted. Based on these findings, a diagnosis of ectopic pancreatitis in an iliac intestinal duplication cyst was made. Conclusion Isolated enteric duplication cyst in the root of ileal mesentery and mesenteric Meckel’s diverticulum have similarities. In the present case, the diagnosis of isolated enteric duplication cyst was made since it was found distant from the ileum. It is important to consider the possibility of ectopic pancreatitis when serum pancreatic enzymes are elevated even when the pancreas appears normal.

Intussusception secondary to pathologic lead points (PLPs) is a potential surgical emergency and almost all cases need surgery. The aim of this study was to evaluate the clinical manifestations, physical examinations and surgical outcomes of secondary intussusception (SI) caused by PLPs, as well as to improve the diagnosis and treatment of PLPs in children and infants.We retrospectively reviewed the records of 83 children and infants who were diagnosed with intussusception secondary to PLPs in our institution. The ultimate diagnosis was dependent on histopathological findings under a microscope by a pathologist. Patients were divided into a younger group ( 2 years old) and the older group ( 2 years old) according to age. Patient demographics, clinical manifestations, duration of symptoms, auxiliary examinations, and the presence of pathological lead point were recorded.A total of 83 patients were found with intussusception secondary to PLPs in this study. Patients were aged from 4 days to 14 years, with a mean age of 3.8 years (median 1.5; range 0-14 years). There were 47 cases in the younger group and 36 cases in the older group. The main clinical symptoms were intermittent crying or abdominal pain. PLPs were observed in only ten patients on US (12%). Ten patients underwent enteroscopy examination for further diagnosis, and all the patients had positive findings including seven cases of Peutz-Jeghers syndrome and three cases of benign polyps. Technetium-99 m pertechnetate scans were performed in ten patients and five patients had positive results (50%). Based on the surgical findings, complex/compound is the most common type of intussusception, followed by small intestinal and ileo-colic type. The main types of PLPs were Meckel's diverticulum (n = 31), duplication cyst (n = 19) and benign polyps (n = 13). Meckel's diverticulum and intestinal duplication were the most common causes of secondary intussusception among children younger than 2 years, accounting for 81% (38/47) of the cases. The most common causes of secondary intussusception in children older than 2 years were intestinal polyps, Meckel's diverticulum and Peutz-Jeghers syndrome, accounting for 72% (26/36) of the cases.The presence of a pathological lead point is more likely in older children. The most common types of intussusception secondary to PLPs are complex/compound and small intestinal. Meckel's diverticulum and intestinal duplication were the most common causes of secondary intussusception among younger children and Peutz-Jeghers syndrome and intestinal polyps were commonly seen in older children.

Introduction: Gastroschisis is much less frequently associated with anomalies than omphalocele. The most common associated anomaly is gastrointestinal abnormalities. Intestinal atresia is found in 10–15% of cases of gastroschisis. Intestinal duplication is a very rare association. Case report: We present a unique case of gastroschisis with an associated intestinal (colonic) duplication cyst in a 4 -day -old 36 weeks pre-term, delivered to a primiparous 16 year old mother, presenting on account of anterior abdominal wall defect with protrusion of bowel through a defect on the right side of the umbilical cord. Examination showed a tubular mass protruding through a 3 cm defect on the right side of the umbilical cord, with a narrow appendix -like appendage at the summit. Laparotomy was done within 24 h of admission. Findings include a protruding tubular mass adherent to the serosa and muscularis layer of the mid transverse colon and the adjacent greater omentum. Mass was excised. Results: He did well postoperatively but developed surgical site infection which was managed by daily wound dressing. He was discharged 2weeks post operative and was doing well at last follow up visit. Histopathology confirmed smooth muscle lining of the cyst wall, with interspersed goblet cells within the mucosa. Conclusion: This report underscores the importance of thorough examination of content of gastroschisis for prompt diagnosis of rare anomalies like intestinal duplication. Keywords: Gastroschisis, Duplication cyst

Background Intraperitoneal arterial hemorrhage without trauma is extremely rare. We report two infant cases of intraperitoneal arterial hemorrhage due to intestinal duplication. Case presentation In case 1, a 2-month-old girl experienced sudden intraperitoneal hemorrhage from the middle colic artery with no apparent trauma. Hemostasis was achieved with suturing of the hemorrhage point, but the cause of hemorrhage was still unknown. Computed tomography after the first operation revealed a duodenal duplication cyst and a pseudopancreatic cyst. Percutaneous drainage of the pseudopancreatic cyst was performed, and the contents had high pancreatic amylase. As the size of the duodenal duplication cyst also decreased with this drainage, we suspected that the duodenal duplication cyst was connected to the pseudopancreatic cyst and the arterial hemorrhage. We hypothesized that the pancreatic juice inside the duplication cyst leaked into the intraperitoneal cavity and caused rupture of the arterial wall. Therefore, marsupialization of the duodenal duplication was performed to evacuate the pancreatic juice contained in the cyst toward the native duodenum. The postoperative course was uneventful. In case 2, a 6-month-old boy experienced sudden intraperitoneal hemorrhage without trauma. The hemorrhage site was identified as the ileocecal artery, and hemostasis was achieved with sutures. Tissue near the hemorrhage point was biopsied, because the cause of arterial wall rupture was still unknown. The biopsied tissue was found to be intestinal mucosa. The patient had recurrent abdominal pain after the first operation, and computed tomography showed a duplication cyst located near the hemorrhage point. Therefore, we resected the intestinal duplication. Pathology results showed that the intestinal duplication contained intestinal mucosa, ectopic gastric mucosa, and pancreatic tissue. The postoperative course was uneventful. Conclusion Intraperitoneal arterial hemorrhage without trauma is an extremely rare condition, and identifying its cause is difficult. To our knowledge, this is the first report of intraperitoneal arterial hemorrhage due to intestinal duplication. In cases of unexplained intraperitoneal arterial hemorrhage in infants, intestinal duplication near the hemorrhage point should be suspected.

Introducción: la duplicación gastrointestinal es una ano-malía relativamente rara que puede ocurrir en cualquier nivel desde la cavidad bucal hasta el recto, los casos de duplicación gástrica son aún más raros, y la mayoría de ellos se han reportado en niños. Material y método: en el siguiente trabajo se expone dos casos; número 1: paciente de sexo femenino de 2 años de edad, con presentación clínica de vómitos de contenido alimentario que luego se tornaron biliosos en número de 3-4 ocasiones por día, de 2 días de evolución, dolor abdo-minal difuso de 2 días de evolución, masa abdominal localizada en hemiabdomen derecho. Caso número 2: paciente masculino de 4 días de vida, a quien se realiza ultrasonido obstétrico a las 34 semanas de gestación, donde se evidencia imagen quística nivel abdominal. A ambos casos se le realiza laparotomía exploratoria eviden-ciando en caso número 1: duplicación gástrica al que se le realiza exéresis total y rafia gástrica, y el caso número 2: malrotación intestinal con vólvulo de intestino medio más duplicación intestinal (ileal), al que se le aplica proce-dimiento de Ladd más resección y anastomosis termino terminal ileoileal, ambos pacientes evolucionan de manera satisfactoria. Conclusión: el propósito consiste en describir la presen-tación de ambos casos en la infancia, lo importante de los métodos diagnósticos y de la corrección quirúrgica por diferentes técnicas según la localización del quiste en el tracto gastrointestinal.

This study aims to compare the prevalence and outcomes of surgically correctable congenital anomalies between sexes.Upon registration on PROSPERO (CRD42019120165), a librarian aided in conducting a systematic review using PRISMA guidelines. The five largest relevant studies were included for each anomaly. Cumulative prevalence differences and confidence intervals were calculated, and the Cochran-Mantel-Haenszel test was performed.Of 42,722 identified studies, 68 were included in our analysis. All included anomalies had greater than 1000 patients except duodenal atresia (n = 787) and intestinal duplication (n = 148). Males had a significantly higher prevalence than females in 10/14 anomalies (Hirschsprung's disease, omphalomesenteric duct, congenital diaphragmatic hernia, anorectal malformation, malrotation, esophageal atresia, congenital pulmonary airway malformation, intestinal atresia, omphalocele, and gastroschisis; p 0.001). There was no difference in the prevalence of duodenal atresia or intestinal duplication between sexes (p = 0.88 and 0.65, respectively). Females had a significantly higher prevalence of biliary anomalies (atresia and choledochal cyst).Our study indicates that males have higher prevalence rates of most congenital anomalies. Further investigations are required to illuminate the embryology underlying this sex distribution and whether sex influences outcomes.Systematic review and meta-analysis.Prognostic study, level II.

Hydatid disease or hydatidosis is a worldwide zoonosis disease caused by the tapeworm of Echinococcus granulosus and still widely endemic in Tunisia especially in rural areas where the sheep-dog cycle is dominant. It is an important public health problem in the pediatric age group causing significant morbidity and mortality. We report a case of primary hydatid cyst of the small intestine in a child and we want to highlight the difficulty that we meet in the diagnosis despite the contribution of imaging.

Enteric duplication cysts are rare malformations mostly diagnosed before the age of two, with varied clinical presentations. Ectopic gastrointestinal epithelium can be present, and management involves surgical resection. A three-month-old girl presented with rectal bleeding due to an ileocolic intussusception. Abdominal ultrasound revealed a target sign in the right upper part of the abdomen. At hydrostatic contrast enema, an incomplete reduction of the intussusception was obtained: only a trickle of contrast material entered the terminal ileum. An exploratory laparotomy ensued with manual reduction of the intussusception. At the end of the maneuver, a soft intraluminal mass was palpated within the ileocecal valve. Thus, an ileocecal resection was performed. At histology, an intraluminal enteric duplication cyst was documented, containing ectopic gastric mucosa. Secondary intussusception should be suspected even in infants in case of abnormal findings at hydrostatic contrast enema. Intraluminal enteric duplication cysts may be a rare cause of intussusception.

Congenital lung and chest cage malformations encompass a wide range of diseases caused during the development of the lung and rib cage structures. These anomalies are manifested in different ways, depending on when they are originated and at what level they affect the tracheobronchial path. The concept of congenital lung and chest cage considers lesions of the lung parenchyma: cystic adenomatoid malformation, lung sequestration, and congenital lobar emphysema, along other less common lesions: intestinal duplication and bronchogenic cyst. Antenatal diagnosis is common because of the routine obstetric ultrasound, and therefore many authors have proposed the name of genetic malformations, which would be appropriate. Also, the finding of asymptomatic lesions in infants and children is not infrequent. There is a consensus for surgery repair in patients with symptoms secondary to a congenital malformation. However, in asymptomatic patients, management will depend on location, type of lesions, and risk for surgery.

Introduction. Gastrointestinal duplication is a rare congenital abnormality found in adults. This intestinal duplication may be associated with complications i.e. perforation, bleeding, obstruction and malignancy. Degeneration to malignancy is a basic consideration to treat a radical surgery, which is preventive. This systematic review aims to provide evidences to evaluate the preventive or conservative surgery in the management. Method. A systematic review conducted according to preferred reporting items for systematic review and meta–analysis protocols (PRISMA). Literature search proceeded on PubMed and ScienceDirect using keywords "malignancy arising from adult duplication gastrointestinal "AND" treatment ". All articles are selected based on inclusion and exclusion criteria. The data evaluated included postoperative complications, recurrence, follow–up and recovery. Results. There were eleven articles – which were case reports – analyzed. These articles reported preventive surgery provide a better outcome than conservative one. Conclusion. Case reports in the study showed that 63% of intestinal duplication were developed to malignancy, requiring preventive surgery (level of evidence IV). However, this should be judge with a careful clinical assessment.

The aim is a demonstration of a rare clinical observation of cystic ileal duplication with a complex diagnostic search of the common source of recurrent bleedings. The boy of 7 years was on the treatment at the Research Institute of Emergency Pediatric Surgery and Traumatology due to frequent recurrent gastrointestinal bleeding. There was performed a comprehensive examination, including laboratory and instrumental methods: common blood and urine test, biochemical blood tests, x-rays of the abdomen, scintigraphy, ultrasound of the abdominal organs, esophagogastroduodenoscopy, colonoscopy, video capsule endoscopic study. Results. The complex diagnostic search was performed. On the basis of the video capsule endoscopic examination and radiography of the abdominal cavity there was suspected the cystic duplication of the ileum with ulcerative defects as the source of bleeding. Upon completion of the examination and relief of post-hemorrhagic anemia there was executed the surgical treatment with resection of the changed area of the intestine and anastomosis “end to end”. The postoperative period was uneventful. Conclusion. Recurrent intestinal bleedings and bowel obstruction can be a complication of such rare malformation of the intestinal tube as the intestinal duplication. The use of modern diagnostic and surgical technology provides timely and minimally invasive treatment that leads to the rapid patient recovery, decline in overall costs and the cost of treatment.

Background Meconium peritonitis is an infrequent congenital disease usually caused by perforation of the fetal digestive tract. Meconium peritonitis resulting from intrauterine appendiceal perforation has been rarely reported and is often overlooked during pregnancy. We herein report two cases of fetal appendiceal perforation. Case presentation Two neonates were found to have intestinal distension and gradually increasing ascites antenatally. After birth, diagnostic abdominal punctures revealed meconium peritonitis. Urgent surgery showed both neonates had developed gangrenous appendicitis in utero. Pathological examination supported the diagnosis of fetal appendiceal perforation in both neonates, and one also had deformity of cecal duplication. In the present report, we also review the presentation, diagnosis, pathology, management, and recent literature of fetal appendiceal perforation. Conclusion Meconium peritonitis due to fetal appendiceal perforation is extremely rare, and preoperative diagnosis is almost impossible. However, clinicians should be aware of abnormal gastrointestinal manifestations in the fetus during the antenatal examination. For neonates with severe meconium peritonitis, an early operation with careful intraoperative exploration is necessary.

Objective To determine the etiologies of obscure gastrointestinal bleeding (OGIB) in a Chinese population using a retrospective case series and a systematic analysis of the literatures on OGIB in Chinese patients. Methods A large enteroscopy database in a tertiary endoscopic center was searched to identify patients with OGIB from 2010 to 2016. The patients' characteristics and diagnostic findings were collected and analyzed. A comprehensive search of the literature was carried out to harvest all relevant studies published from 2004 to 2016. Results In total, 708 patients were included in the case series. The most common causes of OGIB were inflammatory diseases (36.3%), non-small bowel lesions (10.2%) and neoplasms (10.0%). A systematic analysis of the literatures included 39 studies providing relevant data for 3145 patients with a pooled detection rate of 84.2%. Inflammatory lesions (27.4%), neoplasms (18.5%), vascular lesions (16.1%) and diverticula or intestinal duplication (11.9%) were the most common causes of OGIB. Conclusions Inflammatory lesions, neoplasms, vascular lesions and diverticula or intestinal duplication are the most common in Chinese OGIB patients, while in pediatric patients diverticula or intestinal duplication, vascular lesions and Crohn's disease are prevalent. Furthermore, the etiologies of OGIB distribute differently across different areas in China.

Background: Intussusception is a rare cause of bleeding per rectum in neonates. Duplication cyst as a pathological lead point for intussusception is rarer too. Case Presentation: A female neonate presented with bilious vomiting and bleeding per rectum. Ultrasonography diagnosed it as intussusception. Intraoperatively, on reduction of intussusception, a mass was found which on histopathological examination (HPE) revealed a duplication cyst. Conclusion: A high index of suspicion is required for an early diagnosis of neonatal intussusception, which is essential for preventing complications and mortality.

Hirschsprung's disease and, more rarely, intestinal duplication can both cause intestinal obstruction in neonates. The simultaneous occurrence of these two diseases is reported in only two studies, and in both cases, intestinal duplication was an incidental finding, as it had not determined clinical intestinal occlusion. This paper reports a unique case of coexistence of the two conditions, with both causing intestinal obstruction, delayed appropriate, and definitive surgical treatment.

Congenital duodenal obstruction (CDO) is one of the most common anomalies presented in the neonatal period of intestinal obstruction, with an incidence of 1:10,000, and Preduodenal Portal Vein (PDPV) is a rare extrinsic cause of CDO. PDPV leads to CDO with a persistent vomiting, impairment of the oral feeding and weight loss, but other publications state an asymptomatic disease that may requires late surgical correction. Prenatal diagnosis of CDO, including PDPV, is evidenced by association of polyhydramnios with a dilated fluid-filled gastric and duodenum and a double-bobble image in the ultrasonography and permits a proper management of associated malformation, delivery, surgery and allows family counseling. PDPV is commonly associated to other intestinal obstruction such as extrinsic (annular pancreas, adhesive bands, malrotation, peritoneal bands, intestinal duplication), and intrinsic (atresia, web and stenosis), and also associated with cardiovascular anomalies, situs inversus, Down’s syndrome and polysplenia. This is full term 5 days old newborn, 2865 g girl, without prenatal diagnosis of CDO. It was not still established PDPV until surgery procedure such as Duodenoduodenostomy (Diamond-Shape) and can guide Paediatric Surgeons that face high intestinal obstruction in the neonate with or without prenatal diagnosis. In the ambulatory follow up after 4 months, baby has developed very well, in breast-feeding associated with formula-feeding with a normal weight gain (average of 550 g/month).

The present study aimed to investigate the use of ultrasound and differential diagnosis to diagnose a fetal abdominal cyst. A retrospective analysis of 41 cases of fetal abdominal cyst, which included ovarian cysts, choledochal cysts, intestinal duplication and mesenteric cysts, was performed. Imaging characteristics of various types of cysts were summarized, compared and discussed. Among 41 fetal abdominal cyst cases, there were 21 cases of ovarian cysts, 11 cases of bile duct cyst, six cases of intestinal duplication and three cases of mesenteric cyst. Each type of fetal cyst had its own distinctive characteristics on abdominal ultrasound examination. Ovarian cysts were located at one side of the bladder, round-shaped and observed in female fetuses; choledochal cysts were located in the hilar, were oblong- or oval-shaped and connected to the bile duct; intestinal duplication was located in the middle of abdomen, close to the intestine, and presented as an intestinal wall-like structure; mesenteric cysts were round-shaped with thin tensionless wall, presented with multiple chambers, and were easily deformable on compression. The findings of the present study demonstrated that a comprehensive analysis of the association between the cyst and its adjacent location, shape, wall thickness, motility and other aspects of dynamic changes via ultrasonography may provide a differential diagnosis of different types of fetal abdominal cysts.

Colonic duplication cyst is an uncommon cause of intussusception in adults. We report a case of caecal duplication cyst in a 24-year-old adult with a 3-year history of recurrent abdominal pain mainly in the periumbilical region. CT and MRI of the abdomen showed a lesion suggesting an caecal duplication cyst within an intussuception. The patient underwent diagnostic laparoscopy and was found to have a caecal duplication cyst acting as a lead point for the intusseception for which laparoscopic-assisted resection was performed. The histological examination confirmed the presence of intestinal duplication cyst without any underlying malignancy.

Rectal Duplication (RD) is a very rare phenomenon with only around 100 cases reported.They make up a merely 5% of all intestinal duplication’s. Most of the rectal duplication‘s are located in the retro rectal space. Presenting symptoms include intestinal obstruction,bladder outlet obstruction,dysuria,pelvic pain,mucous or purulent drainage from the rectum or perianal fistula,rectal bleeding from the presence of heterotopic gastric mucosa,constipation and rectal prolapse. RDs are mostly diagnosed with ultrasound and MRI.Treatment of choice in majority of cases is surgical resection. We report a very unusual case of congenital rectal duplication cyst in a newborn.A male baby was delivered by emergency C-section for maternal pre-eclampsia at 39 weeks gestation with birth weight of 3.9 kg.Initial clinical review revealed a large,shiny,dark bluish cystic type lesion on the right buttock.Ultrasound scan of the right buttock showed a large deep cystic lesion measuring 3 cm in diameter in the right gluteal region.At 16 hours of age,the lesion burst through one centimeter opening discharging copious amount of liquid meconium,resulting in the collapse of the swelling.As a result,he received fluid resuscitation,feeds were withheld and he was started on antibiotics for suspected sepsis. MRI pelvis showed a large fluid filled tubular structure in the presacral space displacing both the rectum and bladder.The imaging also showed dilatation of the upper tracts in relation to both kidneys with displaced and distended bladder.Surgery showed rectal duplication cyst sharing a common wall with the rectum,however,there was no direct connection with the rectal lumen and was successfully excised. The biopsies revealed degenerative and necrotic tissue which was unusual.The presence of meconium could be attributed to the presence of a direct connection with the rectal cavity at some stage of the development. The baby was discharged home post surgery and made full recovery without any complications. To our knowledge,this case is the first to present with gluteal swelling and subsequent rupture yielding liquid meconium.

Introduction Duplications of the gastrointestinal tract are rare congenital anomalies that can occur anywhere throughout the gastrointestinal tract. The reported incidence is 1/4500, and more than 80% occurs before the age of two as an acute abdomen or bowel obstruction. The most common site is Ileum (60%), while the colonic localisation is reported between 4 and 18%. Presentation of the case Herein we report the case of a 35-year-old man, presented at the Emergency Department with fever and localised abdominal pain in the right iliac fossa. Preoperative abdominal ultrasound and CT scan showed a cystic mass of 44 × 43 × 70 mm adjoining the posterior wall of the right colon. He underwent explorative laparoscopy, laparotomy conversion, right hemicolectomy with an intra-operative diagnosis of colonic duplication cyst, confirmed by histology. Discussion The review of the literature showed as the intestinal duplication cysts are rare congenital anomalies. The clinical presentation is variable and depends on the site and the related complications. A surgical approach based on the resection of the involved bowel tract is the treatment associated with the best long-term outcomes. Conclusion It is important to include intestinal duplication in the differential diagnosis of acute abdomen, to ensure the best therapeutic strategy., Highlights • Duplications of the gastrointestinal tract are rare congenital anomalies. • The resection of the involved bowel tract is the treatment associated with the best long-term outcomes. • It is important to include intestinal duplication in the differential diagnosis of acute abdomen.

Congenital intestinal duplications (ID) are rare, having an incidence of 2/10,000 live newborns. It can occur from the base of the tongue to the rectum, but more than 50% of them are localized in the small bowel.

Congenital cystic masses of the tongue even though detected prenatally are diagnostic challenge even at birth. Very rarely an intestinal duplication cyst may present in the oral cavity leading to difficulty in feeding, swallowing and breathing. These are often diagnosed by histopathologically demonstrating the presence of either gastrointestinal or respiratory epithelium or sometimes both. We present a female newborn with a swelling of the tongue in the oral cavity from birth, interfering with feeding and inability to close the mouth. The swelling was excised by total transoral resection and reconstruction of the tongue was done and confirmed as foregut duplication cyst on histopathological examination. The tongue swelling gradually subsided and the neonate was discharged.

Patient: Male, newborn Final Diagnosis: Fetiform teratoma Symptoms: Abdomen distension Medication:— Clinical Procedure: Surgical removal Specialty: Pediatrics and Neonatology Objective: Unknown etiology Background: Teratoma, a tumor containing a variety of tissues, is a broad diagnosis containing mature teratoma, immature teratoma, and teratomas with malignant transformation. The tumor forms during embryological development secondary to unsuccessful migration of primordial germ cells. A specific type of mature teratoma, containing human-like features, is called a fetiform teratoma. The fetiform teratoma is often compared and confused with fetus in fetu, a reabsorbed twin. While these tumors have commonly been described in the gonads, the retroperitoneal location finding on antenatal imaging is rare. The distinction between the aforementioned subtypes is not well established, proving a challenging diagnosis prior to resection. Case Report: We present a case of a newborn male with a prenatal diagnosis of retroperitoneal cystic mass. Although prenatal imaging was obtained, the diagnosis remained unclear. After birth, planned surgical excision on day of life 7 showed the suprarenal mass contained contiguous intestinal elements. Histopathology examination revealed a mature cystic teratoma with multiple tissue types, including colonic, brain, respiratory, lymphatics, and nerves, reminiscent of fetiform teratoma. This case report presents an interesting example of differentiating elements straddling the diagnoses mentioned above. Conclusions: This is the first reported case of fetiform teratoma diagnosed in a newborn and is especially unique for having the element of intestinal duplication within the retroperitoneal mass. The differentiating features of fetus in fetu and fetiform teratoma depend on subjective distinctions. The case provides an opportunity to discuss the differentials and management strategies.

The aim of this study was to review the ultrasonographic features of secondary intussusception (SI) in children and assess the value of ultrasound in the diagnosis of pediatric SI. The authors performed a retrospective analysis on the ultrasound findings of 1977 cases of primary intussusception (PI) and 37 cases of SI in children. The SI cases were diagnosed by ultrasonography and confirmed by laparotomy or histopathologic diagnosis. The clinical and ultrasonographic features were analyzed and compared between these two groups. The age, no flatus or defecation, position, diameter and length of intussusception, the presence of free intraperitoneal liquid, and intestinal dialation at the proximal end present, all contributed to the differentiation between PI and SI (all P < 0.05). Ultrasound was able to demonstrate the pathological lead point (PLP) shadows in all of the 37 SI cases, either in the cervical part or intussusceptum of the intussusception. Among the 37 SI patients, 21 cases (56.8 %) were accurately categorized with lesions, including intestinal polyps, cystic intestinal duplication, intestinal wall lymphoma, and a small part of Meckel's diverticulum. Ultrasound can be used as a feasible and effective method to discriminate PI from SI. Once the PLP is detected, a definite diagnosis can be made. • The clinical and ultrasonographic features were compared between SI and PI. • The age, location, diameter and length of intussusception, and intestinal dilation were distinguishing features. • The causes of SI were found to be polyps, intestinal duplication, lymphoma, and Meckel's diverticulum. • Ultrasound can be used as an important method to diagnose SI. • Demonstration and confirmation of PLP are vital to diagnosing SI.

Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance to other abdominal processes at imaging, the differential diagnosis may be very difficult. This case report describes a young female adult accessed twice to our Emergency Department with recurrent pain in the right iliac fossa and a clinical picture of abdominal pain and bowel obstruction, who was finally diagnosed with complicated duplication cyst, then resected. The diagnostic tools performed show the simple duplication cyst at the beginning, in the ileocecal region, with the characteristic “gut signature” at Ultrasound and its subsequent inflammatory changing at Computed Tomography, which led to the right diagnostic hypothesis, confirmed by histopathology. An early diagnosis of this condition is needed to undertake the correct surgical approach.

The rare intestinal duplication cyst may be the cause of small intestinal obstruction in an infant. It is an important differential diagnosis for recurrent abdominal pain in the paediatric age group. The clinical diagnosis is often difficult and the diagnosis may sometimes be made only at laparotomy.