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INTRODUCTION AND SIGNIFICANCE: This is a rare case of enteric duplication cyst presenting as ileocolic intussusception in a child. The literature review found that there have been only a few other reported cases of this condition. In most cases, enteric duplication cysts are asymptomatic and are found incidentally. However, in some cases, they can cause symptoms such as abdominal pain, vomiting, constipation, and diarrhea. Intussusception is a rare complication of enteric duplication cysts. CASE PRESENTATION: We present a case of a enteric duplication cyst in the cecum that was discovered through its association with a ileocolic intussusception that reached the anus. We diagnosed the ileocolic intussusception through an ultrasound, and during surgery, we discovered the presence of the enteric duplication cyst in the cecum. We resected it and performed a ileocolic anastomosis. CLINICAL DISCUSSION: The treatment for enteric duplication cysts that are causing symptoms is surgery. During surgery, the cyst is removed and the intestine is repaired. CONCLUSION: This case report highlights the importance of considering enteric duplication cyst as a possible cause of ileocolic intussusception in children.
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We present an unusual case of a female neonate presenting with a single midline pelvic cyst. Prenatal imaging was suggestive of multicystic dysplastic kidney (MCDK), but postnatal imaging was atypical for this diagnosis given the location and singular cyst noted. The patient ultimately underwent surgical exploration and was diagnosed with an ectopic MCDK. Ectopic MCDK should be considered in the differential diagnosis of unilocular cystic pelvic lesions identified in the perinatal period.
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INTRODUCTION: Cecal duplication cysts occur only in 0.4% of all the gastrointestinal tract duplication cysts. More than 80% cases present in the first two years of life. However, asymptomatic individuals may also present in adult life. PRESENTATION OF CASE: A female patient of 42 years presented with generalized abdominal pain and multiple episodes of vomiting from one day. A vague tender mass was palpable in the left lumber region, firm in consistency with ill-defined borders and not moving with respiration. Ultrasound shows mild free fluid with internal debrinous echoic area noted in lower abdomen and pelvis along with fatty hepatomegaly. CeCT scan of the abdomen and pelvis shows twisted appearance of the gut and mesentery in right sub-hepatic region. Complete resection and Ileocolic anastomosis was done along with right hemicolectomy. Based on radiological, surgical and pathological findings, the final diagnosis was enteric duplication cyst. DISCUSSION: Based on their location, terminal ileum and ileocecal junction are the most common sites (53 %) with colonic duplication second to it (13%). However, cecal duplication cysts remain the least common with incidence of 0.4 % only. Females are more common than males. However, their exact cause is not known. Possible causes are defective recanalization, fusion of embryonal longitudinal folds, persistant diverticulae of embryonic life and uterine vascular anomalies. CONCLUSION: Enteric duplication cysts most commonly presenting with palpable abdominal mass, pain mimicking appendicitis & bleeding per-rectum. The treatment of choice is resection and ileocolic anastomosis with overall good prognosis. The delay in the diagnosis can lead to high mortality.
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Paediatric dermatology is an expanding subspeciality [...].
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AIM: Retrorectal masses are abnormalities located anatomically in the retrorectal space. A significant proportion are asymptomatic with no malignant potential while others cause symptoms due to mechanical pressure or malignant infiltration. We reviewed and categorised the retrorectal masses encountered over a 30-year time period in a specialist colorectal hospital and describe our management algorithm for consideration by other multidisciplinary teams (MDT). METHODS: This was a retrospective analysis of consecutive patients referred between 1984-2019. A detailed review of clinical presentation, imaging features, postoperative histology and impact on morbidity and anorectal function is reported. RESULTS: A total of 143 patients with median age of 46 years and female preponderance (74%) were reviewed. The commonest presenting symptom was pain (46%) and all malignant cases had symptoms (n = 17). Over the last decade, more asymptomatic patients have presented with a retrorectal mass (33%, p = 0.04) and more patients are opting for surveillance rather than resection (33%, p = 0.013). Increasing age and lesion size were associated with malignancy (p < 0.05). Radiological features associated with malignancy included: solid/heterogeneous component, lobulated borders or locally invasive. Following surgery, complications included chronic pain (40%), poor wound healing (23%) and bowel dysfunction (10%). CONCLUSIONS: The management of retrorectal masses remains complex. There are features, both clinical and radiological, that can help determine the best management strategy. Management should be in a high-volume tertiary centre and preferably through a complex rectal cancer MDT. Long-term sequelae such as chronic pain must be highlighted to patients. We advocate the establishment of an international registry to further record and characterise these rare, potentially troublesome lesions.
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Neoplasias del Recto , Algoritmos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias del Recto/diagnóstico , Neoplasias del Recto/cirugía , Estudios RetrospectivosRESUMEN
BACKGROUND: Cystic abdominal masses are a common main or incidental finding in daily radiological practice; however, differentiation is not always trivial. OBJECTIVES: In children, cystic abdominal masses represent a special feature compared to adults, since the spectrum of congenital lesions must be taken into consideration. The article gives a structured overview of the most common entities. MATERIALS AND METHODS: The standard methods in abdominal imaging in pediatric radiology are ultrasound and MRI. Based on a literature review, the most important differential diagnoses with their characteristics in ultrasound and MRI were compiled. RESULTS AND DISCUSSION: With anatomical classification, presence or absence of solid components as well as the contrast agent behavior in the MRI, the cystic masses can be well differentiated and classified into three groups: congenital and acquired cysts as well as neoplasms.
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Quistes , Abdomen/diagnóstico por imagen , Adulto , Niño , Quistes/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Radiografía , UltrasonografíaRESUMEN
The detection of fetal anomalies has improved in the last years as a result of the generalization of ultrasound pregnancy screening exams. The presence of a cystic imaging in the fetal pelvis is a relatively common finding, which can correspond to a real congenital cystic lesion or result from the anomalous liquid accumulation in a whole pelvic organ, mainly the urinary bladder, the uterus, or the vagina. In selected cases with poor prognosis and/or inconclusive echographic findings, magnetic resonance may bring additional information in terms of the characterization, anatomical location, and real extension of the pathology. This pictorial essay describes the normal pelvic fetal anatomy, as well as the most common pelvic cysts. It also describes the causes of an anomalous distension of the whole pelvic organs detected in utero, with emphasis on prenatal magnetic resonance imaging exams. Moreover, it proposes practical teaching points to reduce the differential diagnosis of these lesions based on the sex of the fetus, the division of the pelvis in anatomical spaces, and the imaging findings of the pathology. Finally, it discusses the real utility of complementary MRI.