Enteric duplication cyst
Enteric Duplication Cyst is a rare congenital condition characterized by the presence of a cystic mass in the gastrointestinal tract. These cysts can occur anywhere along the gastrointestinal tract from the mouth to the anus, but are most commonly found in the ileum, part of the small intestine. Enteric duplication cysts are also known as gastrointestinal duplication cysts or alimentary tract duplications.
Etiology
The exact cause of enteric duplication cysts remains unclear. However, several theories have been proposed to explain their development. One theory suggests that these cysts result from an abnormality in the embryonic development of the gastrointestinal tract during the first trimester of pregnancy. This abnormality may lead to the formation of a duplicate segment of the gastrointestinal tract that lacks an opening to the exterior.
Pathophysiology
Enteric duplication cysts are true cysts, meaning they are lined by a layer of epithelium that is often similar to that of the gastrointestinal tract. These cysts may contain gastric, intestinal, or respiratory type epithelium. The cysts are typically attached to a portion of the gastrointestinal tract but do not communicate with the lumen. They can vary in size and may cause symptoms depending on their location and size.
Clinical Presentation
Symptoms associated with enteric duplication cysts can vary widely depending on the cyst's size, location, and the presence of ectopic tissue. Common symptoms include abdominal pain, vomiting, intestinal obstruction, and palpable abdominal mass. In some cases, the cysts may remain asymptomatic and are discovered incidentally during imaging studies for unrelated reasons.
Diagnosis
The diagnosis of enteric duplication cysts often involves a combination of clinical evaluation and imaging studies. Ultrasound is typically the first imaging modality used, as it can identify cystic structures within the abdomen. Computed tomography (CT) scan and magnetic resonance imaging (MRI) can provide more detailed information about the cyst's location, size, and relationship to surrounding structures. In some cases, endoscopy may be used to further evaluate the cyst.
Treatment
The standard treatment for enteric duplication cysts is surgical removal. The surgical approach depends on the cyst's location, size, and the presence of any complications such as infection or perforation. In some cases, minimally invasive techniques such as laparoscopy can be used to remove the cyst. The prognosis after surgical removal is generally excellent, with most individuals making a full recovery.
Complications
If left untreated, enteric duplication cysts can lead to several complications, including intestinal obstruction, infection, perforation, and, in rare cases, malignant transformation. Early diagnosis and treatment are crucial to prevent these complications.
Conclusion
Enteric duplication cysts are rare congenital anomalies of the gastrointestinal tract that can present with a variety of symptoms. Early diagnosis and surgical treatment are essential for preventing complications and ensuring a favorable outcome.
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Contributors: Prab R. Tumpati, MD