DOI QR코드

DOI QR Code

Cysts of Gastrointestinal Origin in Children: Varied Presentation

  • Tiwari, Charu (Department of Paediatric Surgery, T.N.M.C & B.Y.L. Nair Hospital) ;
  • Shah, Hemanshi (Department of Paediatric Surgery, T.N.M.C & B.Y.L. Nair Hospital) ;
  • Waghmare, Mukta (Department of Paediatric Surgery, T.N.M.C & B.Y.L. Nair Hospital) ;
  • Makhija, Deepa (Department of Paediatric Surgery, T.N.M.C & B.Y.L. Nair Hospital) ;
  • Khedkar, Kiran (Department of Paediatric Surgery, T.N.M.C & B.Y.L. Nair Hospital)
  • Received : 2016.11.07
  • Accepted : 2017.01.06
  • Published : 2017.06.30

Abstract

Purpose: Abdominal cysts of gastrointestinal origin are rare. Their rarity and varied clinical presentations make their pre-operative diagnosis difficult. Methods: Fourteen patients with histological diagnosis of cysts of gastrointestinal origin admitted between 2009 and 2015 were retrospectively analyzed with respect to age, sex, clinical presentation, diagnostic modality, site and type of cyst, management, outcome and follow-up. Results: The mean age at presentation was 4 years and there were six males and eight females. Abdominal pain was the most common presenting symptom. Five patients had an acute presentation-three had distal ileal mesenteric cysts and two had ileal duplication cyst sharing a common wall with ileum. Six patients presented with chronic abdominal pain and lump-three patients had omental cysts and three had mesenteric cysts-two of these in distal ileum and one in sigmoid colon. Two patients presented with antenatally diagnosed palpable abdominal lump. One had a mesenteric cyst of the ileum and the other had a distal ileal duplication cyst which required excision with resection and anastomosis. One patient had an atypical presentation. He was a known case of sickle cell trait and had presented with vague abdominal pain, recurrent cough and multiple episodes of haemoptysis over a period of one year. At laparotomy, gastric duplication cyst was found which was excised completely. Histopathology confirmed the diagnosis. Conclusion: Cysts of gastrointestinal origin are rare and have varied presentation. Surgical excision is the mainstay of treatment. The results and prognosis are good.

Keywords

References

  1. Kirks DR, Merten DF, Grossman H, Bowie JD. Diagnostic imaging of pediatric abdominal masses: an overview. Radiol Clin North Am 1981;19:527-45.
  2. Light DE, Pianki FR, Ey EH. Abdominal mass in an infant. J Am Osteopath Coll Radio 2015;4:23-5.
  3. Makhija D, Shah H, Tiwari C, Jayaswal S, Khedkar K, Waghmare M. Mesenteric cyst(s) presenting as acute intestinal obstruction in children: three cases and literature review. Int J Paediatr Adolesc Med 2016;3:109-11. https://doi.org/10.1016/j.ijpam.2016.04.003
  4. Ghritlaharey RK, More S. Chylolymphatic cyst of mesentery of terminal ileum: a case report in 8 year-old boy. J Clin Diagn Res 2014;8:ND05-7.
  5. Ricketts RR. Mesenteric and omental cysts. In: Grosfeld Jay L, O'Neill JA, Fonkalsrud EW, Coran AG, Caldamone AA, eds. Pediatric surgery. Chapter 89. Mosby Inc., 2006;Vol II:1399-1406.
  6. Casarotto A, Cerofolini A, Denitto F, Invernizzi L, Chiappetta A, Di Prima F, et al. [Mesenteric cyst: case report and review of the literature]. G Chir 2010;31:239-42. Italian.
  7. Chung MA, Brandt ML, St-Vil D, Yazbeck S. Mesenteric cysts in children. J Pediatr Surg 1991;26:1306-8. https://doi.org/10.1016/0022-3468(91)90606-T
  8. Tan JJ, Tan KK, Chew SP. Mesenteric cysts: an institution experience over 14 years and review of literature. World J Surg 2009;33:1961-5. https://doi.org/10.1007/s00268-009-0133-0
  9. Prakash A, Agrawal A, Gupta RK, Sanghvi B, Parelkar S. Early management of mesenteric cyst prevents catastrophes: a single centre analysis of 17 cases. Afr J Paediatr Surg 2010;7:140-3. https://doi.org/10.4103/0189-6725.70411
  10. Beahrs OM, Judd ES Jr, Dockerty MB. Chylous cysts of the abdomen. Surg Clin North Am 1950;30:1081-96. https://doi.org/10.1016/S0039-6109(16)33090-0
  11. de Perrot M, Brundler M, Totsch M, Mentha G, Morel P. Mesenteric cysts. Dig Surg 2000;17:323-8. https://doi.org/10.1159/000018872
  12. Pampal A, Yagmurlu A. Successful laparoscopic removal of mesenteric and omental cysts in toddlers: 3 cases with a literature review. J Pediatr Surg 2012;47:e5-8.
  13. Liaqat N, Latif T, Khan FA, Iqbal A, Nayyar SI, Dar SH. Enteric duplication in children: a case series. Afr J Paediatr Surg 2014;11:211-4. https://doi.org/10.4103/0189-6725.137327
  14. Calder J. Enteric duplication cyst. Med Essays Obs 1733;1:205.
  15. Lund DP. Almentary tract duplications. In: Coran AG, Adzick NS, eds. Pediatric surgery. 7th ed. Philadelphia: Elsevier, 2012:1155.
  16. Ildstad ST, Tollerud DJ, Weiss RG, Ryan DP, McGowan MA, Martin LW. Duplications of the alimentary tract. Clinical characteristics, preferred treatment, and associated malformations. Ann Surg 1988;208:184-9. https://doi.org/10.1097/00000658-198808000-00009
  17. Rasool N, Safdar CA, Ahmad A, Kanwal S. Enteric duplication in children: clinical presentation and outcome. Singapore Med J 2013;54:343-6. https://doi.org/10.11622/smedj.2013129
  18. Blank G, Konigsrainer A, Sipos B, Ladurner R. Adenocarcinoma arising in a cystic duplication of the small bowel: case report and review of literature. World J Surg Oncol 2012;10:55. https://doi.org/10.1186/1477-7819-10-55
  19. Sheikh MA, Latif T, Shah MA, Hashim I, Jameel A. Ileal duplication cyst causing recurrent abdominal pain and melena. APSP J Case Rep 2010;1:4.
  20. Shafi SM, Malla MA, Reshi FA. Giant primary omental cyst mimicking a pseudoascites. Afr J Paediatr Surg 2009;6:58-60. https://doi.org/10.4103/0189-6725.48581
  21. Vanek VW, Phillips AK. Retroperitoneal, mesenteric, and omental cysts. Arch Surg 1984;119:838-42. https://doi.org/10.1001/archsurg.1984.01390190076018
  22. Perriello VA Jr, Flemma RJ. Lymphangiomatous omental cyst in infancy masquerading as ascites. J Pediatr Surg 1969;4:227-30. https://doi.org/10.1016/0022-3468(69)90396-0
  23. Burnett WE, Rosemond GP, Bucher RM. Mesenteric cysts. Arch Surg 1950;60:699-706. https://doi.org/10.1001/archsurg.1950.01250010720006
  24. Aiken JJ. Intestinal duplications. In: Oldham KT, Colombani PM, Foglia RP, Skinner MA, eds. Principles and practice of pediatric surgery. Philadelphia: Lippincott Williams and Wilkins, 2005:1329-45.
  25. Uramatsu M, Saida Y, Nagao J, Takase M, Sai K, Okumura C, et al. Omental cyst: report of a case. Surg Today 2001;31:1104-6. https://doi.org/10.1007/s595-001-8068-0
  26. Hebra A, Brown MF, McGeehin KM, Ross AJ 3rd. Mesenteric, omental, and retroperitoneal cysts in children: a clinical study of 22 cases. South Med J 1993;86:173-6. https://doi.org/10.1097/00007611-199302000-00005

Cited by

  1. Intestinal duplication revealed by posterior reversible encephalopathy syndrome vol.61, pp.4, 2017, https://doi.org/10.3345/kjp.2018.61.4.132
  2. A huge completely isolated duplication cyst complicated by torsion and lined by 3 different mucosal epithelial components in an adult : A case report vol.97, pp.44, 2017, https://doi.org/10.1097/md.0000000000013005
  3. Enteric duplication cysts in children: varied presentations, varied imaging findings vol.9, pp.6, 2018, https://doi.org/10.1007/s13244-018-0660-z
  4. Completely Isolated Enteric Duplication Cyst and Incidental Neuroendocrine Tumor of the Appendix: A Case Report vol.21, pp.None, 2017, https://doi.org/10.12659/ajcr.923988
  5. An ileal duplication cyst case report: From diagnosis to treatment vol.16, pp.7, 2017, https://doi.org/10.1016/j.radcr.2021.03.007
  6. Fussiness and New-Onset Diarrhea for 2 Weeks in a 9-week-old Girl vol.42, pp.10, 2017, https://doi.org/10.1542/pir.2020-002691
  7. A retroperitoneal supra-adrenal non-communicating gastric duplication cyst: a case report and comprehensive literature review vol.17, pp.1, 2017, https://doi.org/10.1186/s43159-021-00078-8
  8. Omental cyst: a case report and review of the literature vol.17, pp.1, 2017, https://doi.org/10.1186/s43159-021-00129-0