RESUMO
Alimentary tract duplication cyst refers to congenital malformations that involve the mesenteric side of bowel and share a common wall or blood supply with the bowel. Duplication cyst occurs in any segment of the gastrointestinal tract from mouth to anus, but is more commonly seen in the mesentery of the ileo-colic region. Duplication cyst presents more frequently in children with abdominal pain or swelling. In adults, the diagnosis of duplication cyst is incidental and can present with complications like bleed, fistula formation, inflammatory mass, and rarely malignant transformation. English-language literature review has shown only three cases of malignancies reported so far associated with jejunal duplication cyst. A case of incidentally detected metastatic adenocarcinoma in a jejunal duplication cyst is being reported here, along with literature review of malignancies associated with small bowel duplication cyst.
RESUMO
BACKGROUND: Although colorectal cancer (CRC) may not be uncommon in India, accurate data regarding its demographics and surgical outcomes is sparse. METHODS: With an aim to assess demographics and perioperative outcomes of CRC in Kerala, all members of Association of Surgical Gastroenterologists of Kerala (ASGK) were invited to participate in a registry. Data of operated cases of CRC were entered on a web-based questionnaire by participating members from January 2016. Analysis of accrued data until March 2018 was performed. RESULTS: From 25 gastrointestinal surgical centers in Kerala, 15 ASGK member hospitals contributed 1018 CRC cases to the database (M:F 621:397; median age-63.5 years [15-95 years]). Rectum (39.88%) and rectosigmoid (20.33%) cancers comprised the majority of the patients. Among them, preoperative bowel preparation was given to 37.68%, minimally invasive surgery (MIS) was performed in 73%, covering stoma in 47% and had an overall leak rate of 3.58%. In colonic malignancies, MIS was performed in 56.74%, covering stoma created in 13% and had a leak rate of 2.71%. Of 406 patients with rectal cancers, neo-adjuvant radiotherapy/chemoradiotherapy was given to 51.23%. The mean hospital stay for MIS in both rectal and colonic cancer patients was significantly shorter than open approach (10.46 ± 5.08 vs. 12.26 ± 6.03 days; p = 0.001and 10.29 ± 4.58 vs. 12.46 ± 6.014 days; p = <0.001). Mortality occurred in 2.2% patients. CONCLUSION: A voluntary non-funded registry for CRC surgery was successfully created. Initial data suggest that MIS was performed in majority, which was associated with shorter hospital stay than open approach. Overall mortality and leak rate appeared to be low.