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CC BY 4.0 · Endoscopy 2025; 57(S 01): E1144-E1145
DOI: 10.1055/a-2686-2862
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Submucosal tunneling endoscopic resection for the treatment of infantile gastric duplication cyst: the first report in infants

Authors

  • Hanhua Zhang‡

    1   Department of Gastroenterology, Xi’an Children’s Hospital and National Regional Medical Center for Children (Northwest), Shaanxi, China

  • Huanyu Liu‡

    1   Department of Gastroenterology, Xi’an Children’s Hospital and National Regional Medical Center for Children (Northwest), Shaanxi, China

  • Xiaoxia Ren

    1   Department of Gastroenterology, Xi’an Children’s Hospital and National Regional Medical Center for Children (Northwest), Shaanxi, China

  • Kuku Ge

    1   Department of Gastroenterology, Xi’an Children’s Hospital and National Regional Medical Center for Children (Northwest), Shaanxi, China

  • Pinghong Zhou

    2   Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China (Ringgold ID: RIN92323)

  • Ying Fang

    1   Department of Gastroenterology, Xi’an Children’s Hospital and National Regional Medical Center for Children (Northwest), Shaanxi, China

Gefördert durch: Key Research Project of Shaanxi Province 2025SF-YBXM-237
Gefördert durch: Shaanxi Children’s Digestive Health Research and Innovation Platform 2024PT-14
Gefördert durch: Xi’an Children’s Hospital Support Project 2023H02
Gefördert durch: Xi’an Health Commission Training Base Project 2024zp05
Gefördert durch: Xi’an Health Commission Scientific Research Project – General Cultivation Project 2024ms06
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A 5-month-old boy, diagnosed with gastric duplication by fetal magnetic resonance examination and occasional vomiting after birth. Abdominal ultrasonography showed a cystic mass in the left upper abdomen with gastric duplication. Abdominal CT examination: cystic mass at the esophagogastric junction, esophageal/gastric duplication ([Fig. 1] a). Submucosal tunneling endoscopic resection (STER) was performed ([Video 1]). During the procedure, an extragastric cyst at the esophagogastric junction, diagnosed as a gastric duplication malformation ([Fig. 1] b, c). At 16 cm from the incisors, a Helabot knife performed submucosal injection and mucosal incision on the esophageal posterior wall ([Fig. 1] d). A submucosal tunnel was established toward the cardiac lesion, revealing a cystic protrusion. Using an IT knife, circumferential dissection was performed, followed by en bloc resection with a disposable snare ([Fig. 1] e, f). Minor bleeding at the resection site and tunnel was controlled by electrocoagulation at seven points using a thermal biopsy forceps. The tunnel entrance was closed with seven disposable titanium clips ([Fig. 1] g, h). The pathological diagnosis was gastric duplication ([Fig. 1] i). After 20 months of follow-up, the patient had no special discomfort and developed well.

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Submucosal tunneling endoscopic resection for treatment of infantile gastric duplication cyst.Video 1

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Fig. 1 Submucosal tunneling endoscopic resection for treatment of infantile gastric duplication cyst. a Abdominal CT before STER, gastric repetitive malformation cyst was found at the esophagogastric junction (white arrow). b Gastroscopy revealed a submucosal tumor at the esophagogastric junction. c Endoscopic ultrasound showed a submucosal cyst. d Submucosal incision. e The cyst was cut open after the tunnel was completed. f Complete excision of cyst. g Closed tunnel opening. h A segmented cyst. i Gastric duplication was diagnosed by pathology.

Gastric duplication in children is a rare malformation of the digestive tract, with an incidence of about 17 per 1 million [1]; the only option is surgical resection. Ye et al. reported a case of a gastric duplication cyst associated with an ectopic pancreas that was successfully resected with ESD [2]. The STER technology enhances the resection of lesions by creating a submucosal space prior to the procedure, thereby preserving the mucosal layer. This technique leverages the bodyʼs natural cavities to optimize surgical outcomes. STER represents an innovative surgical approach for the treatment of gastric duplication malformations and warrants consideration for integration into clinical practice.

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Artikel online veröffentlicht:
07. Oktober 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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