Gastric triplication with peritoneal melanosis: A case report

Abstract

Background: Gastrointestinal duplications are uncommon congenital anomalies. Triplications of the intestinal tract are exceptionally rare, with only five cases reported in literature until now. Triplications of the stomach have only been reported three times and only one time in combination with peritoneal melanosis. Case presentation: A 1.5-year-old female presented to the outpatient clinic with abdominal distension that had started several weeks prior. It was associated with occasional non-bilious, non-projectile vomiting, and intermittent diarrhea. The physical exam revealed a mass in the left hemi-abdomen. An ultrasound of the abdomen revealed a cystic structure of approximately 8 × 6 cm in diameter in the left hemi abdomen. A contrast-enhanced computerized tomography (CT) of abdomen and pelvis revealed the same cystic mass, which was suspicious for an enteric duplication. The patient underwent an exploratory laparotomy during which two cysts were found attached to the wall of the stomach. One was in the lesser sac, 6 × 8 cm in size, and attached to the posterior wall of the stomach, covered by pigmented visceral peritoneum. The second cystic lesion was located along the greater curvature, was 10 × 7 cm in size, and was also covered by pigmented peritoneum. Pathology confirmed that both cysts had gastric mucosa and had melanocytes on the outer surface. Partial excision with mucosal stripping was done for both cysts. The patient recovered uneventfully. Conclusion: While intestinal triplications are exceedingly rare, all cases of intestinal duplication should be evaluated for additional lesions. Peritoneal melanosis is a rare but benign condition in children and requires no treatment.

Keywords

• Gastric triplication
• Enteric duplication
• Peritoneal melanosis
• Abdominal mass
• Case report