Mesenteric, Omental, and Duplication Cysts
Ann Alyssa Kurian
Duplication Cysts
EPIDEMIOLOGY AND ETIOLOGY
Location of cysts:3
Gastric—3% to 4% of all duplication cysts
Intestinal—45% to 55% of all duplication cysts
Duodenal—5% to 6% of all duplication cysts
Colon—15% of all duplication cysts
Rectal—8% of all duplication cysts
Multiple cysts present in 10% to 20% of cases2
GI duplication cysts associated with vertebral, spinal cord, or genitourinary anomaly in 30% to 50% of cases1
Etiology—4 theories exist
Split notochord: endoderm separates from the notochord to form the GI tract; herniations or abnormal deposits of endodermal cells can occur during this process leading to duplications2,3
Incomplete recanalization: error in creation of gut lumen; duplication may arise from abnormal diverticula2,3
Environmental factors2
CLINICAL PRESENTATION
They are often asymptomatic and discovered as an incidental finding.2
Duplications can be cystic or tubular.
Symptoms at presentation can vary depending on location, size, and mucosal features.
Duplication in the chest can present with wheezing, pneumonia, and dysphagia.
Duplication in the abdomen can present as abdominal pain, vomiting, and abdominal mass. Large cysts can cause extrinsic compression of adjacent bowel and present with obstructive symptoms.
Cysts containing gastric mucosa can present with bleeding (melena), ulceration, or perforation.
Large gastric duplications can present like hypertrophic pyloric stenosis with symptoms of gastric outlet obstruction.
Duodenal duplication cysts can lead to recurrent pancreatitis.
Duplications arising from the ileum can present like appendicitis, difficult to differentiate preoperatively.
Small intestine duplications can act as a lead point and cause intussusceptions.
Colon and hindgut duplication can present as a second opening in the perineum and can cause symptoms of constipation and urinary obstruction from mass effect.2
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