Endoscopy 2018; 50(04): S190
DOI: 10.1055/s-0038-1637621
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

DUODENAL DUPLICATION CYST TREATED ENDOSCOPICALLY AFTER AN EPISODE OF INFECTION

M Sousa
1   Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
,
L Proença
1   Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
,
S Fernandes
1   Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
,
A Costa
1   Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
,
J Rodrigues
1   Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
,
J Silva
1   Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
,
J Carvalho
1   Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

Aims:

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Methods:

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Results:

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Conclusions:

A 21-year-old woman was admitted to the emergency department for acute abdominal pain. Laboratory tests revealed leukocytosis (16.35 × 103/uL) and elevated C Reactive Protein (20.53 mg/dL) with normal amilase and lipase. An ultrasound and subsequently a computed tomography scan showed a duodenopancreatic cystic inflammatory lesion with 30 × 24 mm in the third portion of the duodenum with edema of the surrounding mucosa and fat, corresponding to an infected duplication cyst or an infected diverticulum. Antibiotics were initiated and she was discharged asymptomatic after 13 days and referred for consultation.

Endoscopic ultrasound was performed showing a submucosal anechoic, well delimited lesion in the second portion of the duodenum with 18 × 11 mm arising from the submucosa. It was therefore submitted to endoscopic guided fenestration by performing an incision of the cyst with Mori knife. A guidewire was placed into the cyst and the cyst wall was deroofed using a sphincterotome. The opening was further widened with a ballon with drainage of transparent fluid.

The patient remains asymptomatic after 6 months of follow-up and a reminiscent of the cyst was observed in endoscopy.

Duodenal duplication cysts are rare and usually asymptomatic and incidentally discovered. Cyst infection has been described in few cases. Symptomatic duodenal duplication cyst generally mandate treatment. Surgical therapy is associated with significant morbi-mortality. As shown in this case, endoscopic treatment is safe and effective.