Incidentally discovered enteric duplication cyst: a case report

Abstract

Enteric duplications are rare congenital diseases with heterogeneous clinical pictures ranging from an asymptomatic course to life-threatening consequences, most commonly arising at the ileal and ileocecal region. The antenatal discovery is possible when it concerns a voluminous cystic form enabling an early management. The radiologic examinations are nonspecific and no diagnostic tools can allow a certain diagnosis on its own. Sometimes, the diagnosis of intestinal duplication is only made during the surgical exploration and confirmed after a histopathological examination. We report a 4 years old girl with antenatal diagnosed ovarian cystic mass of about 4 mm. She was admitted to our unit for abdominal pain and constipation. Abdominal ultrasonography showed a cystic mass in the right iliac fossa. MRI revealed a well-defined cystic mass (6 x 4.2 x 5.4 cm) in the right mid abdomen displacing the bowel to the left, likely to be strongly adherent to the last part of the ileum. 99mtc pertechnetate scan was negative for ectopic gastric mucosa. A laparoscopic approach was eventually necessary and the diagnosis of duplication cyst was confirmed. Children with antenatal diagnosis of abdominal mass need a close follow up and enteric duplication should be considered as potential diagnosis. The laparoscopic approach has an important role in differential diagnosis between intestinal duplications and other mass.

Keywords

• enteric duplication
• ileocecal resection
• ileocecal valve/junction
• abdominal mass