Intestinal Duplications: Our experience and Review of Literature

Rajesh Gupta [1], Divya Tomar [1], Aradhana Singh [1], Anjali Gupta [2]

[1] Sarojini Naidu Medical College, Mantola, Agra 282003, Uttar Pradesh, India

[2] Anjali Ultrasound and Colour Doppler Centre, Agra 282003, Uttar Pradesh, India

Keywords

Abdominal pain

Bowel surgery

Gastrointestinal bleeding

Intestinal Duplication

Intestinal obstruction 

Mesenteric cysts

Abstract

Introduction: Gastrointestinal duplication cysts (GIDC) are rare and they occur anywhere from the oro-pharynx to the anal canal. They can be cystic or tubular and they may or may not have communication with the lumen of the adjacent bowel. Accordingly, they have varying clinical presentation. In this article we share our Indian experience with GIDC.

Methods: This study is a retrospective analysis of 6 cases of GIDC treated over a 3-year period (2013-16). Case records were reviewed for details of clinical presentation, nature of treatment and outcome.

Results: All the patients were below 6 years of age with presentations ranging from intestinal obstruction to gastrointestinal hemorrhage and pain. The male-female ratio was 5:1. One of them had a congenital isolated duplication cyst, which is very rare. The duplicated bowel was cecum in 2, jejunum in 2 and colon in 1. Pre-operative diagnosis was made in all except one patient who presented with features of intestinal obstruction. Ultrasonography and computed tomography scan were the main imaging modalities of diagnosis. They were treated by segmental resection in 3 children and cyst enucleation in 1 case. Histopathology confirmed the diagnosis. Four patients did well in the follow-up, 1 died and 1 was referred elsewhere. 

Conclusions: GIDC commonly presented with subacute intestinal obstruction. With modern imaging studies, preoperative diagnosis is possible in a majority of cases. Final outcome is consistently good.