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Poster - 132
Cystic intestinal duplication across different bowel segments: a report of two cases with divergent presentations
Radomir Stankovic 1, Ivona Djordjevic 2, Ana Kostic 1, Nikola Vacic 1
1 Clinic for Pediatric surgery, Orthopedics and Traumatology, University Clinical center Niš, Serbia
2 1. Clinic for Pediatric surgery, Orthopedics and Traumatology, University Clinical centre Niš, Serbia; 2. Faculty of Medicine, University of Niš, Serbia
Introduction: Enteric duplication cysts are rare congenital anomalies that may occur anywhere along the gastrointestinal tract, from the mouth to the anus. Although several embryological theories have been proposed, none fully explains the diversity of these lesions. While they may remain asymptomatic, symptomatic cases usually present before the age of two years. Clinical presentation depends on the lesion's type, location, size, and mucosal lining and may include life-threatening complications such as gastrointestinal bleeding, intussusception, volvulus, and bowel perforation. The aim of presenting these two cases is to contribute to the understanding of this rare entity with nonspecific yet potentially life-threatening clinical manifestations.
Case presentation: We present two pediatric cases of cystic enteric duplication with distinct clinical presentations. An 11-month-old infant was admitted with an acute abdomen and rectal bleeding. Digital rectal examination revealed a cystic mass within the rectal lumen, while computed tomography demonstrated a unilocular cystic lesion extending from the urinary bladder to the retrorectal space. Complete cyst enucleation was performed using a posterior sagittal anorectoplasty (PSARP) approach, and the specimen was submitted for histopathological examination. The second case involved an 8-month-old infant presenting with intermittent cramp-like abdominal pain and vomiting. Physical examination revealed localized tenderness of the right hemiabdomen. Ultrasonography demonstrated an aperistaltic concentric-ring lesion suggestive of intussusception. After an episode of bloody stool, emergency exploratory laparotomy confirmed an ileocolic intussusception. Following manual reduction, an intraluminal mass measuring 2–3 cm was identified. Partial right hemicolectomy with primary end-to-end ileocolic anastomosis was performed, and the specimen was sent for histopathological examination.
Conclusion: The broad spectrum of clinical manifestations and the risk of serious complications emphasize the importance of early recognition and timely surgical treatment of enteric duplication cysts. Familiarity with these rare congenital anomalies is essential for accurate diagnosis and optimal patient outcomes.