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Duodenal duplication cyst account for 4% or 5% of all gastrointestinal duplications. Duodenal duplication acting as a lead point for an intussusception is an extremely rare event as it is largely a fixed retroperitoneal structure. We report here on the radiologic findings of a case of duodenal duplication cyst that manifested as duodeno-jejunal intussusception in an adult.

We report an unusual case of duodenal duplication presenting in a newborn with duodenal and bile duct obstruction. The duplication and biliary tract were filled with keratinaceous casts. To our knowledge, such an association has not been previously reported; this case demonstrates the importance of confirming bile duct patency during operations to remove duodenal duplications.

Cystic duplication of the duodenum is a rare anomaly of the gastrointestinal tract. Patients may present in early childhood with symptoms of upper intestinal obstruction. Successful, staged management of a cystic duodenal duplication in an 880-g infant is described.

A duodenal duplication cyst in a 45-year-old male is reported. A hypotonic duodenography showed a smooth spherical defect in the descending portion of the duodenum. A fiberoptic duodenoscopy disclosed a smooth well-defined tumor which was located orally from the ampulla of Vater. A retrograde pancreatocholangiography indicated the tumor was not in communication with the pancreatic duct or biliary tract. At operation, a cystic spherical mass, 3 cm in diameter, was located in the posterior wall of the duodenum corresponding to the above described diagnosis. The combination of a greater awareness of this condition as well as improved X-ray and endoscopic techniques has made preoperative diagnosis more accurate.

Duodenal duplication cysts are rare congenital lesions. Their presentation is often non-specific and physical examination and laboratory studies usually reveal no abnormal findings. The diagnosis of duodenal duplication cysts can thus be challenging and relies on ultrasonography, barium swallow, contrast enhanced computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance cholangiopancreatography (MRCP). The management of duodenal duplication cyst is surgical. Laparotomy is usually necessary, and complete resection is the management goal. Subtotal excision with stripping of the mucosa due to close involvement of the pancreatobiliary tree, and endoscopic resection have Duodenal duplication cysts are rare congenital lesions usually diagnosed in infancy, although they may present in adulthood. Prenatal diagnosis is difficult, and postnatal diagnosis relies on ultrasonography, barium swallow, contrast-enhanced computerized tomography, magnetic resonance imaging (MRI), and magnetic resonance cholangiopancreatography. A female newborn was diagnosed with an abdominal cyst (size around 6 ×; 5 × 4 cm) at gestational age (GA) 24 weeks, by regular prenatal examination. After her birth at GA 37 weeks, we performed abdominal ultrasonography and MRI, but there was no definite diagnosis. The usual management of an abdominal cyst involves resection by laparotomy (requiring a large incision) or laparoscopy (requiring several small incisions). We performed an exploratory trans-umbilical minimal laparotomy excision for surgery, and the pathology revealed duodenal duplication. In our case, there was no recurrence of the cyst after 18 months follow-up, and the operation scar was almost undetectable. Trans-umbilical minimal laparotomy excision may be considered as an alternative choice for the management of abdominal and duodenal duplication cysts.

A duodenal duplication cyst containing enteroliths in an adult patient is presented. The preoperative diagnosis was established by computed tomographic (CT) and ultrasound (US) examinations. To the best of our knowledge this is the first description of enteroliths in a duodenal duplication cyst.

Seven cases of duodenal duplication in the adult are reported. The ultrasound and computed tomographic findings are analyzed. The relationship between duodenal duplication and pancreatitis is discussed.

Duodenal duplication cyst is an uncommon congenital anomaly of the alimentary tract and preoperative diagnosis is important in relation to the surgical approach. This paper describes a beak-like projection of the duodenum in contrast studies which enabled a confident preoperative diagnosis of duodenal duplication cyst in four infants.

Calcification of intestinal duplications is rare, and it is most uncommon in duodenal duplications. In this report, two cases illustrate distinct forms of calcification associated with duodenal duplication cysts. Each type may be confused with calcifications in other benign or malignant lesions. Calcified duodenal duplication cysts should be considered when investigating spherical upper abdominal calcifications.

A large intrahepatic duodenal duplication connected to the duodenum by two openings is described. No similar cases of intrahepatic cysts have been found in the literature. The patient, a forty-four year old woman, had recurrent and numerous bouts of right upper quadrant pain over many years before the intrahepatic portion of the cyst was drained by a Roux-en-Y anastomosis after the connections with the duodenum had been excised.

A case which presented with early cancer of the duodenal duplication in addition to a gallbladder defect is reported. This may be the first case of its kind reported in the literature.

A case is reported of an adult patient with a history of relapsing pancreatitis. A soft duodenal submucosal lump was found by endoscopic retrograde cholangio-pancreaticography (ERCP). Endoscopic ultrasonography (endo-US) showed an anechoic lesion covered with normal duodenal wall structure. Histology of the surgically resected cyst confirmed the diagnosis. Since surgery no further attacks of pancreatitis have occurred.

DUPLICATIONS of the duodenum are commonly thought to represent a surgical problem occurring in infancy. A careful review of the literature reveals, however, that 33% of patients reported were 20 years of age or older.1-14 As these lesions usually cause obstruction and require surgical management, it is important for surgeons who are dealing primarily with adult patients to be aware of duodenal duplications and be familiar with their operative management should such a rare case be encountered. This report describes a patient who presented with a duodenal ulcer and obstruction from a duodenal duplication at 51 years of age. Report of Case A 51-year-old white man was admitted to the Ann Arbor Veterans Administration Hospital on July 26, 1965, with a three-week history of nausea, vomiting, and a 15.9-kg (35 lb) weight loss. He had been free of gastrointestinal symptoms except for a brief episode of nausea, vomiting, and

A case of transdiaphragmatic duodenal duplication in a premature infant is presented. Vertebral abnormalities, which have invariably accompanied this disorder in reported cases so far, were characteristically absent. Therefore, the initial tentative diagnosis was right-sided diaphragmatic hernia. Barium examination was helpful in preoperative diagnosis.

Duplications are congenital lesions, spherical or tubular in shape and composed of a muscular wall with a gastrointestinal lining. They may be found at any level from the mouth to the anus, and are usually intimately attached to some portion of the gastrointestinal tract (1, 2). The endoscopic removal of both primary duodenal polyps and prolapsing antral polyps which cause outlet obstruction has been previously described. We report a case of a symptomatic duplication cyst of the apex of the duodenal bulb, which was removed endoscopically. A patient with outlet obstruction symptoms due to a duplication cyst of the duodenal apex is described. Complete cessation of symptoms followed endoscopic removal of the cyst.

Duplications can occur anywhere in the alimentary tract from mouth to anus. There may be multiple duplications in about 15% of cases. The most common site is in the distal ileum, in over 50% of cases. Duodenal duplications are rare, and occur in only 5-10% of the total in recent reviews (3, 5, 7). Three cases of this very uncommon abnormality are reported.