Retroperitoenal enterogenous cyst with colonic duplication cyst
: case report of 9-month-old infant
Young Ju Hong, Seonae Ryu, Eun Young Chang and Seok Joo Han
Department of Pediatric surgery, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
Background
B
B
Enterogenous cyst is
- rare congenital lesion of endodermal derivation
- related to
intrauterine volvulus with subsequent ischemia and infarction
persistence of intrauterine diverticulum
incomplete vacuolization of solid alimentary tract
Complete isolated enterogenous cyst
- rare variant of enteric duplication cyst
Unrecognized , asymptomatic cysts
be the site of adenocarcinoma during adult life.
Coexistence of a enterogenous cyst with a classic enteric duplication cyst
- has been reported only twice earlier in the literature
Case
An 9-month-old russian boy presented with chronic constipation and prenatal detected
intra-abdominal cystic mass. He gave a history of constipation after starting solid food
and a gradual increase in the intra-abdominal mass size past nine months(0.9->8.0
cm).
A simple abdomen film showed gas distended bowel loop in the upper abdomen(Figure
1).
Untrasound showed multilobulated and septated cystic lesion with internal debris in
right upper abdomen(Figure 2).
Figure 5
Under the impression of retroperitoneal cystic lymphangioma and enteric duplication cyst,
the operation was conducted. Operative finding revealed pancreatic origin mass rather
than cystic lymphangioma.
Gross specimen pictures
A. figure 7 : retroperitoneal mass
B. figure 8,9,10 : colonic duplication cyst
A
A
Figure 7
B
Figure 1
Figure 6
B
Figure 8
B
Figure 2
A Computed tomography scan confirmed and retroperitoneal cystic mass but could not
comment on the origin. It showed features of a cystic lymphangioma (Figure 3, 4).
A
A
Figure 9
Histopathology of the A. retroperitoneal cystic mass revealed congenital enterogenous cyst
having esophagus, stomach and colonic wall, while the B. duplication cyst adjacent to
cecum had heterotopic gastric tissue and partly communicated with colonic wall
Figure 3
Figure 3
Figure 10
Figure 4
On the Barium enema study, bowel caliber change or passage delay were not shown,
instead, medial side of cecum was filled with contrast and showed dilated bowel loop.
This bowel loop had blind end and was thought to have duplicated bowel loop
(Feagure 5,6).
Conclusion
This represents third case in the literature of retroperitoenal enterogenous cyst with
enteric duplication cyst.
Awareness of varied presentation of enterogenous cysts wound help in appropriate
management during surgery without any confusion.